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HIPAA

We have supplied all of our HIPAA Privacy forms and a copy of our Notes of Privacy Practices.
  1. Authorization to Use and Disclose Specific Protected Health Information Form (PDF)
  2. List of Designated Privacy Officials (PDF)
  3. Notes of Privacy Practices (PDF)
  4. Patient Request for Access Form (PDF)
  5. Patient Request for Restriction Form (PDF)
  6. Procedure for Filing Complaints About Privacy Practices (PDF)
  7. Request for Amendment of Protected Health Information Form (PDF)
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