PDF
Word
WCC Form A-25R Authorization for Disclosure of Health Information - Maryland
What Is WCC Form A-25R?
This is a legal form that was released by the Maryland Workers' Compensation Commission - a government authority operating within Maryland. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is WCC Form A-25R?A: WCC Form A-25R is the Authorization for Disclosure of Health Information form used in Maryland.
Q: What is the purpose of WCC Form A-25R?A: The purpose of WCC Form A-25R is to authorize the disclosure of health information.
Q: Who needs to fill out WCC Form A-25R?A: Anyone who wants to authorize the disclosure of their health information in Maryland needs to fill out WCC Form A-25R.
Q: Is there a fee for submitting WCC Form A-25R?A: No, there is no fee for submitting WCC Form A-25R.
Q: Who should I contact if I have questions about WCC Form A-25R?A: If you have questions about WCC Form A-25R, you should contact the Maryland Workers' Compensation Commission.
Form Details:
- Released on May 1, 2019;
- The latest edition provided by the Maryland Workers' Compensation Commission;
- 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 fillable version of WCC Form A-25R by clicking the link below or browse more documents and templates provided by the Maryland Workers' Compensation Commission.
