Share your health information with loved ones

We are committed to protecting your health information. At some point during your care, you may need to share your health information with someone else — or, access a family member’s information.

Completing our authorization form gives Sharp Health Plan permission to share your personal health information. You control who you want to share that information with, and the level of information that you what to share with them. There are two options for you to choose from on the form:

• Option 1: All health information (includes medical and financial information)
  • Medical — e.g., diagnoses, doctors, treatments
  • Financial — e.g., medical claims, bills, copayments
• Option 2: Only limited information that you specify

DOWNLOAD FORM

If you are legally responsible for making medical decisions for a Sharp Medicare Advantage member, you will need to submit this form in order to access their health information.

Important note

This authorization form is for Sharp Health Plan only.

You will need to fill out additional authorization forms and submit them to your medical group, doctor’s office or locations where you receive care. We encourage you to contact your doctor’s office for more information.

How do I get my medical group’s authorization form?

You can find your medical group on your member ID card.

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Sharp Direct Advantage is offered by Sharp Health Plan. Sharp Health Plan is an HMO with a Medicare contract. Enrollment with Sharp Health Plan depends on contract renewal. Read the full disclaimer.

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