Form HIPPA206A Turquoise Lodge Authorization to Disclose Health Information - New Mexico

Form HIPPA206A Turquoise Lodge Authorization to Disclose Health Information - New Mexico

What Is Form HIPPA206A?

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

FAQ

Q: What is HIPPA206A Turquoise Lodge Authorization to Disclose Health Information?A: HIPPA206A Turquoise Lodge Authorization to Disclose Health Information is a form used in New Mexico for authorizing the disclosure of health information.

Q: Who uses the HIPPA206A form?A: The HIPPA206A form is used by individuals who want to authorize the disclosure of their health information by Turquoise Lodge, a health facility in New Mexico.

Q: What information is disclosed with the HIPPA206A form?A: The HIPPA206A form authorizes the disclosure of various health information, including medical history, treatment records, and mental health records.

Q: How can I obtain the HIPPA206A form?A: You can obtain the HIPPA206A form from Turquoise Lodge or by contacting the health facility.

Q: Is the HIPPA206A form specific to New Mexico?A: Yes, the HIPPA206A form is specific to New Mexico and is used by Turquoise Lodge.

Q: Can I use the HIPPA206A form for other health facilities?A: No, the HIPPA206A form is specific to Turquoise Lodge and cannot be used for other health facilities.

Q: Is the HIPPA206A form legally binding?A: Yes, the HIPPA206A form is legally binding and allows Turquoise Lodge to disclose your health information as authorized.

Q: How long is the HIPPA206A form valid for?A: The validity of the HIPPA206A form may vary, but it typically remains in effect until revoked or a specific expiration date is mentioned on the form.

Q: Can I revoke the authorization granted through the HIPPA206A form?A: Yes, you can revoke the authorization granted through the HIPPA206A form at any time by providing written notice to Turquoise Lodge.

Q: Can someone else fill out the HIPPA206A form on my behalf?A: Yes, someone else can fill out the HIPPA206A form on your behalf if you have given them the legal authority to act on your behalf, such as through a power of attorney.

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Form Details:

  • The latest edition provided by the New Mexico Department of Health;
  • 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 Form HIPPA206A by clicking the link below or browse more documents and templates provided by the New Mexico Department of Health.

Download Form HIPPA206A Turquoise Lodge Authorization to Disclose Health Information - New Mexico

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  • Form HIPPA206A Turquoise Lodge Authorization to Disclose Health Information - New Mexico, Page 1
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