Forms

HIPAA

• Authorization to Release Protected Health Information (PHI)
  
  
• Business Associate Agreement
  
  
• FERPA Form for Sharing of Student PHI Among NCSU Covered Health Care Components (Consent for Release of Health Information)
  
  
• Counseling Center Authorization For Release of Health Information
  
  
• General Consent For Treatment And Consent To Use And Disclose Health And Medical Information For Treatment, Payment And Health Care Operations (Counseling Center)
  
  
• General Consent For Treatment And Consent To Use And Disclose Health And Medical Information For Treatment, Payment And Health Care Operations
  
  
• FERPA Form For Release of Student Athlete PHI To The Media And Parent/Guardian
  
  
• FERPA Form for Release of Student Athlete PHI to Pro Sports Teams
  
  
• Health Care Components Notice of Privacy Practices
  
  
• FERPA Form For Release of Student Athlete PHI to Selected Athletics Personnel
  
  
• HIPAA Compliant Form for Use to Obtain Student Athlete PHI From Third Party Providers Or Health Care Plans (Authorization For Release of Health Information)
  
  
  
• Occupational Medicine Exam Request Form and Authorization for Release of Medical Information
  
  
• Patient Authorization Form - To Permit Use And Disclosure Of Health Information

Facilities Operations

• Request For Fire Alarm System Disconnect

Real Estate

• NCSU Lease Request For Space - Exhibit 1
  
  
• PO-27 Form - Exhibit 2
  
  
  
• Approval Authority - State Prosperty Transactions - Exhibit 3
  Centennial Campus Disposition by Lease Space in Buildings - Exhibit 4
  
  
• Real Estate Check List for Development Officers - Exhibit 5

 * External Forms section are being developed