DDU Form 900 Authorization for Release of Protected Health Information - New Hampshire

Notification Icon This version of the form is not currently in use and is provided for reference only. Download this version of DDU Form 900 for the current year.

DDU Form 900 Authorization for Release of Protected Health Information - New Hampshire

What Is DDU Form 900?

This is a legal form that was released by the New Hampshire Department of Health and Human Services - a government authority operating within New Hampshire. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DDU Form 900?A: DDU Form 900 is an Authorization for Release of Protected Health Information.

Q: Who needs to complete DDU Form 900?A: Any individual or entity that wants to request the release of protected health information from New Hampshire.

Q: What is the purpose of DDU Form 900?A: The purpose of DDU Form 900 is to obtain permission to release protected health information to a specified recipient.

Q: What information is required on DDU Form 900?A: DDU Form 900 requires information such as the patient's name, date of birth, the specific information being released, the recipient's name and contact information, and the purpose of the release.

Q: Is there a fee for submitting DDU Form 900?A: No, there is no fee for submitting DDU Form 900.

Q: How long does it take to process DDU Form 900?A: The processing time for DDU Form 900 may vary, but it is typically processed within a few business days.

Q: Is DDU Form 900 specific to New Hampshire?A: Yes, DDU Form 900 is specific to the state of New Hampshire and may not be applicable in other states.

Q: Who can receive the released protected health information?A: The released protected health information can only be received by the recipient specified on the DDU Form 900.

ADVERTISEMENT

Form Details:

  • Released on May 1, 2015;
  • The latest edition provided by the New Hampshire Department of Health and Human Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of DDU Form 900 by clicking the link below or browse more documents and templates provided by the New Hampshire Department of Health and Human Services.

Download DDU Form 900 Authorization for Release of Protected Health Information - New Hampshire

4.7 of 5 (25 votes)
  • DDU Form 900 Authorization for Release of Protected Health Information - New Hampshire, Page 1
ADVERTISEMENT

Related Documents