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Form F-13155 HIPAA Privacy Amendment Request - Wisconsin Chronic Disease Program (Wcdp) - Wisconsin
What Is Form F-13155?
This is a legal form that was released by the Wisconsin Department of Health Services - a government authority operating within Wisconsin. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form F-13155?A: Form F-13155 is the HIPAA Privacy Amendment Request.
Q: What is the Wisconsin Chronic Disease Program?A: The Wisconsin Chronic Disease Program (WCDP) is a program that provides assistance to eligible Wisconsin residents with chronic diseases.
Q: What is the purpose of the HIPAA Privacy Amendment Request?A: The purpose of the HIPAA Privacy Amendment Request is to allow individuals to request changes to their protected health information (PHI) that is maintained by the Wisconsin Chronic Disease Program (WCDP).
Q: Who is eligible for the Wisconsin Chronic Disease Program?A: Eligibility for the Wisconsin Chronic Disease Program is based on income and residency requirements. Individuals with chronic diseases who meet these requirements may be eligible for assistance.
Q: How can I submit the Form F-13155 HIPAA Privacy Amendment Request?A: The Form F-13155 HIPAA Privacy Amendment Request can be submitted by mail or fax to the Wisconsin Chronic Disease Program (WCDP).
Form Details:
- Released on August 1, 2020;
- The latest edition provided by the Wisconsin Department of Health 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 fillable version of Form F-13155 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Health Services.
