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Authorization to Use or Disclose Protected Health Information template - Download from Accounting and Finance-Agreements

 
Home>Accounting and Finance> Agreements
Accounting and Finance
 
 
Document Sample
Document Description
This form is used by an individual to consent to the use or disclosure of protected health information as described within. The individual also indicates the acknowledgment of his or her rights regarding consent to the use and disclosure of the information.
 
 
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