HIPAA Employee Medical Release Letter (WORD) - Spanish

This letter should be signed by the Bureau Chief and provided to the employer/medical facility/doctor, etc., when the OSH Division has the right to access certain medical records per HIPAA without employee consent. CSHOs should first attempt to gain employee consent whenever possible using the employee medical release form. The Spanish translation was created in 2023 and updated in 2025 with new logo.

Document Information

Document Number: HMR 5a Span
Effective Date:

Archived Versions

Title File Name Archived Date
Medical release letter- Spanish 2023.docx(archived) Medical release letter- Spanish 2023.docx

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