DSHS Form 10-489 Confidential Health Information Consent Agreement - Washington (Chinese)

DSHS Form 10-489 Confidential Health Information Consent Agreement - Washington (Chinese)

This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington.

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

FAQ

Q: What is DSHS Form 10-489?A: DSHS Form 10-489 is the Confidential Health Information Consent Agreement in Washington.

Q: What does the form consent to?A: The form consents to the release of confidential health information.

Q: Who is the form for?A: The form is for individuals in Washington who wish to authorize the release of their confidential health information.

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

ADVERTISEMENT

Form Details:

  • Released on April 1, 2019;
  • The latest edition provided by the Washington State Department of Social and Health Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of DSHS Form 10-489 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.

Download DSHS Form 10-489 Confidential Health Information Consent Agreement - Washington (Chinese)

4.3 of 5 (83 votes)
  • DSHS Form 10-489 Confidential Health Information Consent Agreement - Washington (Chinese)

    1

  • DSHS Form 10-489 Confidential Health Information Consent Agreement - Washington (Chinese), Page 2

    2

  • DSHS Form 10-489 Confidential Health Information Consent Agreement - Washington (Chinese), Page 1
  • DSHS Form 10-489 Confidential Health Information Consent Agreement - Washington (Chinese), Page 2
Prev 1 2 Next
ADVERTISEMENT

Related Documents