HIPAA authorization for Pennsylvania
A HIPAA authorization lets the people you name receive information about your health. It does not let them decide anything.
Free with an account.
This one is free. What you pay for any other document counts in full toward a package.
Who this is for
- Your child has just turned 18 and you can no longer call their doctor.
- You want a sibling or a friend able to get an update when you are in hospital.
- You are the one people would call, and you want it in writing before you need it.
- You are building the rest of your plan and want the information side covered too.
What it does not do
- It shares information. It grants no authority to make a single decision about your care.
- It does not override a provider's own forms. Many hospitals and universities keep their own release process, and you may be asked to sign theirs as well.
- It is not a promise that a hospital will refuse to speak to your family without one. Federal guidance already lets providers use professional judgment when a patient is incapacitated. The authorization removes the guesswork.
How to sign it in your state
Pennsylvania
HIPAA Authorization
The principal signs before two qualified witnesses; notarization is not a substitute for the witness ceremony.
- Witnesses: 2, and they must be present at the signing.
- Notary: no. Notarization is not used for this signing route.
Who cannot witness: The healthcare agent may not witness. Use witnesses who are not signing on the principal's behalf.
20 Pa.C.S. § 5452
New York
HIPAA Authorization
The principal signs before two adult witnesses. Do not notarize this healthcare-proxy execution.
- Witnesses: 2, and they must be present at the signing.
- Notary: no. Notarization is not used for this signing route.
Who cannot witness: The appointed healthcare agent may not serve as a witness.
N.Y. Public Health Law § 2981
New Jersey
HIPAA Authorization
Use either two adult witnesses or the document's notary/attorney acknowledgment route.
- Witnesses: 2, or use the acknowledgment route printed on the document instead.
- Notary: an alternative to the witnesses, not an addition to them.
Who cannot witness: Do not use the designated healthcare representative as a witness.
N.J.S.A. 26:2H-56
Get started
This is the smallest useful piece of an estate plan and the one most people are missing. It answers a single question: who is allowed to be told.
It is worth being precise about what it does not do, because the two documents get confused constantly. Information is not authority. Someone holding your HIPAA authorization can be given your test results. They cannot consent to a procedure, choose a facility, or decline treatment. For that, someone has to be named in a healthcare power of attorney.
Airlooms gives this document away with an account, and it is the same generated document as the one inside the packages, with your state's signing instructions attached.
Common questions
Is this the same as a medical power of attorney?
No, and the difference matters. A HIPAA authorization lets the people you list receive information. A medical power of attorney lets one person make decisions. Many people want both, and they are usually signed at the same time.
Why is it free?
It grants no authority over money, property, or another person, free versions of it already exist, and having one makes the rest of your plan easier to finish. Charging for it would buy nothing but friction. You do need an account so the document can be saved.
My child just turned 18. Is this what I need?
It is the piece that lets a provider talk to you. If you also want to be able to decide, your child would need to sign a healthcare power of attorney naming you. Both are their choice to make, not yours.
Does it need witnesses?
Pennsylvania and New Jersey use the same signing route as the other healthcare documents, generally two adult witnesses. Airlooms prints the exact route for your state on the document.
How long does it last?
Until you revoke it, or until any expiry date you set in the document. You can revoke it in writing at any time.
Included in
- Decisions, $29 for 5 documents, 22% less than buying the pieces. See what is in it
- Will & Essentials, $69 for 18 documents, 55% less than buying the pieces. See what is in it
- Trust & Property, $129 for 28 documents, 57% less than buying the pieces. See what is in it