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California HIPAA Medical Release Form

    https://eforms.com/images/2016/10/California-HIPAA-Medical-Release-Form.pdf
    California Hospital Association Page 3 of 3 Form 16-1 Authorization for Use or Disclosure of Health Information. another authorization for such disclosure is obtained from me or …

RELEASE OF CLIENT/RESIDENT MEDICAL …

    https://www.cdss.ca.gov/cdssweb/entres/forms/English/LIC605A.pdf
    The person who authorized this release may revoke this authorization at any time. 2. The person who authorized this release has a right to receive a copy of the release. 3. This …

Authorization For Use or Disclosure of Patient …

    https://mydoctor.kaiserpermanente.org/ncal/Images/318413%20-%20English%20Medical%20Release%20form_tcm75-333216.pdf
    Permanente Medical Groups. NS-9934 (2-11) HIPAA COMPLIANT SPANISH-NS-1614; CHINESE-NS-6274 90258 (REV. 2-11) SPANISH 01782-000; CHINESE 01782-002. …

Medical Records Release Authorization …

    https://eforms.com/release/medical-hipaa/
    Article IV shall seek to establish why the Patient is authorizing the release of his or her medical information. If Patient consent is given for a “General …



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