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CA CDCR 7385 2009 free printable template

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STATE OF CALIFORNIAAUTHORIZATION FOR RELEASE OF PROTECTED HEALTH INFORMATIONDEPARTMENT OF CORRECTIONS AND REHABILITATIONCDCR 7385 (Rev. 11/14)Form: Page 1 of 2 Instructions: Pages 3 & 4All sections
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How to fill out CA CDCR 7385

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How to fill out CA CDCR 7385

01
Obtain the CA CDCR 7385 form from the California Department of Corrections and Rehabilitation website or your nearest correctional facility.
02
Read the instructions carefully to understand the purpose of the form.
03
Fill in your personal information at the top of the form including your name, inmate number, and other identifying details.
04
Provide the required information about your legal and correctional history as requested in the various sections of the form.
05
Check the boxes or fill in the blanks according to your situation as accurately as possible.
06
Review the entire form to ensure all information is complete and accurate.
07
Sign and date the form at the designated area.
08
Submit the completed form as instructed, either by mailing it to the appropriate department or delivering it in person.

Who needs CA CDCR 7385?

01
Individuals who are incarcerated in California and require documentation of their correctional status.
02
Inmates applying for certain programs or benefits that require proof of their status or behavior while incarcerated.
03
Family members or representatives who need to advocate for the inmate's rights or needs.
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(a) Patients may authorize the release of their health care information by completing the CDCR 7385, Authorization for Release of Protected Health Information, to allow a family member or friend to request and receive an update when there is a significant change in the patient's health care condition.
To request review or release of your CDCR health care records or information, you should complete a CDCR Form 7385 (Authorization for Release of Protected Health Information). A copy of the 7385 form is attached to this letter. You should do your best to fill out all sections of the 7385 form.
CDCR 7385, Authorization for Release of Protected Health Information.
Generally, an authorization provides the authority for a doctor's release of PHI for specified purposes, which are generally other than treatment, payment, or healthcare operations, or, to disclose protected health information to a third party specified by the individual.
Emergency Treatment If you need emergency care, an ER doctor may need to request and view your medical records in order to make the best possible treatment decisions.

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CA CDCR 7385 is a form used by individuals in California's Department of Corrections and Rehabilitation system to report specific information regarding their correctional status and obligations.
Individuals who are under the jurisdiction of the California Department of Corrections and Rehabilitation, including parolees and those serving specific sentences, are required to file CA CDCR 7385.
To fill out CA CDCR 7385, individuals must provide personal details, outline their correctional status, and report any required information as specified in the form instructions, ensuring that all sections are completed accurately.
The purpose of CA CDCR 7385 is to collect essential data that aids the Department of Corrections and Rehabilitation in monitoring the activities and compliance of individuals under its jurisdiction.
Information that must be reported on CA CDCR 7385 includes personal identification details, current address, compliance with parole conditions, and any relevant updates to the individual's legal status.
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