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HIPAA Authorization School Nurse Clinic School Name: I. Release of Information: I hereby authorize the school nurse clinic to share PHI of (student's name) as follows: The student's PHI that may be
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School nurse clinic is a facility within a school that provides basic healthcare services to students.
The school administration or designated health personnel are required to file school nurse clinic.
To fill out school nurse clinic, the school administration or designated health personnel must document the health services provided to students.
The purpose of school nurse clinic is to promote the health and well-being of students by providing healthcare services and promoting healthy habits.
Information such as the number of students seen, services provided, and any referrals made must be reported on school nurse clinic.
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