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HIPAA AUTHORIZATION FORM FOR USE OR DISCLOSURE OF HEALTH INFORMATION

 

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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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