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Office of the Chief Security Officer

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Photo of the publication cover. Authorization to Disclose Health Information (English) Security Office - Form June 4, 2024

This authorization allows the Department of Health (DOH) to disclose confidential health information about you. The authorization may be revoked. It will remain in effect for six (6) months unless a different time is stated. You are entitled to a copy of the completed authorization. There may be fees charged for any copying associated with this request. If you are a person with a disability and you require this authorization in an alternative format or require a special accommodation to complete this form, you may request assistance from staff at any DOH location or from the DOH Chief Privacy Officer.

Authorization to Disclose Health Information (Spanish)



Photo of the publication cover. Health Information Privacy Policy Security Office - Policies, Protocols & Procedures October 1, 2010

The New Mexico Department of Health is required by law to keep your health information private and to tell you our legal duties and privacy practices. This document explains what kinds of information we collect, what we do with the information, who else can see your information, what your rights are, how to register a complaint, and more.

Health Information PolĂ­tica de Privacidad