HIPAA Authorization for Family Members and Agents
An HIPAA Authorization for Family Members and Agents, drafted for your facts, that lets the people who need your medical information actually get it during a crisis.
Drafted from your facts and your transaction, not adapted from a form book. A full custom draft written from how your business actually operates, so the document describes real practice rather than an aspiration.
Choose the version you need
- Standard$975This page
- Short Form$725
- Long Form$1,550
- Review and Redline$725
- Template and Playbook$1,475
Frequently asked questions
The fee covers a full custom draft built from your intake answers, a cover note explaining the choices that matter and why, and an editable word file and a clean pdf. It is fixed at this scope: one principal. 2 rounds of revisions are included. If your matter falls outside that scope we tell you before starting and quote the difference—we do not bill past a flat fee without agreeing it first.
2 business days from a complete set of instructions, plus time for the 2 rounds of revisions included in the fee. If you are working to a court deadline or a closing date, tell us when you order and we will confirm in writing whether we can meet it before you commit.
$975 is $325/hour × 3 hours—the time this deliverable takes in an ordinary incapacity planning matter, at the firm's standard rate. Because it is a flat fee, the risk of the work running long sits with the firm: you pay $975 whether it takes us the estimate or twice it.
2 rounds of revisions are included. You can add more when you order, or later, at $325 per additional round. A round is one consolidated set of your comments and our revised draft back to you.
Third-party costs are never inside a flat fee and are passed through at cost, never marked up: court and agency filing fees, court reporter and transcript charges, expert witness fees, search vendor and e-discovery hosting charges, process server fees, and travel.
What your business does, and who its users or customers are, the systems, vendors, and data flows the document has to describe accurately, any existing version, and what prompted this one, and any regulator, platform, or contract requirement you are working to. Send what you have—if something is missing we will tell you what else we need before the turnaround clock starts.
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