Patient Authorization for Release of PHI

Patients can authorize Protected Health Information (PHI) and/or Sensitive Protected Health Information (SPHI) disclosure to a particular person or entity by signing this authorization form.

File Size: 38.5 KB
File Type: .doc - Word document
File Name: Patient_Authorization_for_Release_of_PHI.doc
Download Patient_Authorization_for_Release_of_PHI.doc

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