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