Shield Law notice form

New York’s Shield Law (N.Y. General Business Law Section 394-i) prohibits disclosure of records or information related to receiving, providing, or helping someone access reproductive or gender-affirming health care — known as “legally protected health activity” — except under limited circumstances. Any individual or entity that receives a subpoena or information request about legally protected health activity must take certain steps before it may provide any information in response to the request, including notifying the Office of the Attorney General (OAG).

To notify OAG that you or the entity you represent has received a subpoena or information request about legally protected health activity, use the form below. You must include a copy of the subpoena or information request and any related materials (such as the required affirmation and any court order). You must notify OAG within 5 business days of receiving the request or 5 business days prior to any compliance deadline, whichever comes first, and you must wait 30 days after notifying both OAG and affected individuals before you may produce any information in response to the request. To learn more about these requirements and when they apply, consult OAG’s Shield Law Guidance.

Note: This form is only required for subpoenas or information requests that are about legally protected health activity—which means requests that are focused on or ask for certain information related to legally protected health activity.  

Notice to OAG is also not required if the request is any of the following: 

• A written request by a patient or their legal representative for the release of their own records, or accompanied by an authorization, consent form, or HIPAA release signed by the patient or their legal representative, permitting release of the records
• Accompanied by a valid court order enforceable in New York, including a subpoena so-ordered and signed by a judge, that eliminates the requirement to notify OAG   
• Disclosures related to medical treatment or routine medical billing
• A written request made by the subject of an investigation into legally protected health activity
• Made in connection with a government audit or grant reporting requirement

You do not need to complete this form if one or more of these circumstances applies. See OAG’s Shield Law Quick Guide.