Use this chart with the Harner Legal Forms HIPAA Authorization Revocation to withdraw a prior authorization for the use or disclosure of protected health information.
Last reviewed: September 28, 2026
Important: This page provides general state-law information, not legal advice. It addresses an ordinary transaction or revocation using the Harner Legal Forms document. Laws, agency forms, local procedures, mandatory notices, consumer rules, and institutional practices can change. State and federal law control if they differ from this summary or the form instructions.
Recommended steps
- Identify the authorization being revoked and sign the revocation in writing.
- Deliver it directly to every covered entity that was authorized to use or disclose the information; delivery to a third party alone may not be effective.
- Keep proof of receipt and ask the covered entity to place the revocation in its records.
- Understand that revocation is prospective and generally does not undo disclosures already made in reliance on a valid authorization.
Scope of this chart
The federal baseline applies nationwide. HHS explains that revocation must be in writing and is not effective until the covered entity receives it. See HHS guidance on revoking a HIPAA authorization. State medical-privacy law may provide additional protections.
| State | Revocation method | Additional state-law point |
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No matching state found.