Patient Information Brochures

For a Spanish version of the brochure, please click here

Consent Forms 

Third-party identification for all consent forms is required to process your request. Please be aware that HASA has 72 hours from the time your request is received to update the system. Your request can be submitted through any participating provider or by having it signed by a Notary Public and faxing it to 210-918-1376.

To download the HASA Opt-Out Request Formclick here. (By completing this form your information will not be available to physicians and other healthcare providers). 
For a Spanish version of the form, click here.

To download the HASA Revoke Opt-Out Form, click here. (If you change your mind and want to share your information, please submit this form). 
For a Spanish version of the form, click here.