Patient Request for Accounting of PHI Disclosures

This form allows a patient or their representative to request an accounting of how their Protected Health Information (PHI) was disclosed

File Size: 61.5 KB
File Type: .doc - Word document
File Name: Patient_Request_for_Accounting_of_PHI_Disclosures.doc
Download Patient_Request_for_Accounting_of_PHI_Disclosures.doc

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