Form DOH-5032HT Authorization for Release of Health Information (Including Alcohol / Drug Treatment and Mental Health Information) and Confidential HIV / AIDS-Related Information - New York (Haitian Creole)

Form DOH-5032HT Authorization for Release of Health Information (Including Alcohol / Drug Treatment and Mental Health Information) and Confidential HIV / AIDS-Related Information - New York (Haitian Creole)

This is a legal form that was released by the New York State Department of Health - a government authority operating within New York.

The document is provided in Haitian Creole. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the purpose of form DOH-5032HT?A: The purpose of form DOH-5032HT is to authorize the release of health information, including alcohol/drug treatment and mental health information, as well as confidential HIV/AIDS-related information.

Q: Who is the form for?A: The form is for individuals in New York who need to give their authorization for the release of their health information in Haitian Creole.

Q: What information can be released with this form?A: This form allows for the release of health information, including alcohol/drug treatment and mental health information, as well as confidential HIV/AIDS-related information.

Q: Is this form specific to New York?A: Yes, this form is specific to New York.

Q: Is the form available in Haitian Creole?A: Yes, the form is available in Haitian Creole.

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Form Details:

  • Released on April 1, 2011;
  • The latest edition provided by the New York State Department of Health;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of Form DOH-5032HT by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the New York State Department of Health.

Download Form DOH-5032HT Authorization for Release of Health Information (Including Alcohol / Drug Treatment and Mental Health Information) and Confidential HIV / AIDS-Related Information - New York (Haitian Creole)

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  • Form DOH-5032HT Authorization for Release of Health Information (Including Alcohol / Drug Treatment and Mental Health Information) and Confidential HIV / AIDS-Related Information - New York (Haitian Creole), Page 1
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