UA-203549015-1 HIPAA AUTHORIZATION FORM | Calla Women's Health
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HIPAA AUTHORIZATION FORM FOR USE OR DISCLOSURE OF HEALTH INFORMATION

 

This form is for use when such authorization is required and complies with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Standards. 

1 HIPAA AUTHORIZATION FOR USE OR DISCLOS
2 HIPAA AUTHORIZATION FOR USE OR DISCLOS
Click Here to download the PDF  form:
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