Form WCB-220-C Limited Release of Medical / Health Care Information Related to HIV / AIDS and Sexually Transmitted Diseases - Maine

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Form WCB-220-C Limited Release of Medical / Health Care Information Related to HIV / AIDS and Sexually Transmitted Diseases - Maine

What Is Form WCB-220-C?

This is a legal form that was released by the Maine Workers' Compensation Board - a government authority operating within Maine. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form WCB-220-C?
A: Form WCB-220-C is a document used in Maine to release limited medical/health care information related to HIV/AIDS and sexually transmitted diseases.

Q: Why would someone need to use Form WCB-220-C?
A: Someone may need to use Form WCB-220-C to authorize the release of their medical/health care information related to HIV/AIDS and sexually transmitted diseases in specific situations.

Q: What information is released with Form WCB-220-C?
A: Form WCB-220-C releases limited medical/health care information related to HIV/AIDS and sexually transmitted diseases, as specified on the form.

Q: Who can access the released information?
A: Only authorized individuals or entities as specified on Form WCB-220-C can access the released information.

Q: Is there a fee for obtaining Form WCB-220-C?
A: There may be a fee associated with obtaining Form WCB-220-C. You should check with the healthcare provider or facility for more information.

Q: How long is Form WCB-220-C valid for?
A: The validity period of Form WCB-220-C may vary depending on the specific circumstances. It is best to consult with the healthcare provider or facility for the expiration details.

Q: Can I revoke the release of information granted by Form WCB-220-C?
A: Yes, you can revoke the release of information granted by Form WCB-220-C at any time. You should follow the specified procedure on the form to do so.

Q: Is Form WCB-220-C specific to Maine?
A: Yes, Form WCB-220-C is specific to Maine. Other states may have their own forms or procedures for authorizing the release of medical/health care information related to HIV/AIDS and sexually transmitted diseases.

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Form Details:

  • Released on September 1, 2018;
  • The latest edition provided by the Maine Workers' Compensation Board;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form WCB-220-C by clicking the link below or browse more documents and templates provided by the Maine Workers' Compensation Board.

Download Form WCB-220-C Limited Release of Medical / Health Care Information Related to HIV / AIDS and Sexually Transmitted Diseases - Maine

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  • Form WCB-220-C Limited Release of Medical / Health Care Information Related to HIV / AIDS and Sexually Transmitted Diseases - Maine, Page 1
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