What is a Provider Authorization Form?

The Provider Authorization Form gives HealthLock permission to contact your healthcare providers, notifying them that your personal medical information is continuously monitored and protected. 

By completing this form, you give HealthLock permission to include a notice in your medical file indicating that your private health information (PHI) is protected from unauthorized access, including potential misuse by criminals or other entities.

Under federal privacy laws, your providers are required to include the HealthLock Provider Authorization Form in your medical record once it’s submitted. This ensures your data remains secure and that your healthcare information is monitored with your consent.