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hippa form 2020

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NYCHHC HIPAA Authorization to Disclose Health Information ALL FIELDS MUST BE COMPLETED THIS FORM MAY NOT BE USED FOR RESEARCH OR MARKETING, FUNDRAISING OR PUBLIC RELATIONS AUTHORIZATIONS PATIENT NAME/ADDRESS
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HIPAA stands for health insurance portability and accountability act California has the bone state version called the California confidentiality of medical information act healthcare providers will not release your medical information to others without being provided with a HIPAA authorization you may choose to provide a copy of your HIPAA authorization advance health care directive and health care power of attorney to your health care providers for their information and to retain in York medical records you