Florida Department of Elder Affairs Revocation of Consent or Authorization to Release Protected Heal
An individual can revoke the authorization for the Florida Department of Elder Affairs (DOEA) to use and disclose his/her protected health information to carry out treatment, payment or health care operations.
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However, the DOEA may use and disclose the individual's protected health information after he/she revokes authorization, if DOEA treated the individual and he/she stated on the authorization form that DOEA could use and disclose his/her protected health information for treatment, payment, or health care operations prior to treatment. Individuals can easily complete a revocation of authorization to release information using the Florida Department of Elder Affairs Revocation of Consent or Authorization to Release Protected Health Information (PHI) DOEA Form 187 app.
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