PDF
Word
Form F-12 Use and Disclosures Restriction - Wyoming
What Is Form F-12?
This is a legal form that was released by the Wyoming Department of Health - a government authority operating within Wyoming. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form F-12?A: Form F-12 is a document used to impose restrictions on the use and disclosure of protected health information.
Q: Who uses Form F-12?A: Form F-12 is typically used by healthcare providers or organizations in Wyoming.
Q: What is the purpose of Form F-12?A: The purpose of Form F-12 is to protect the privacy and confidentiality of a patient's health information.
Q: What does Form F-12 restrict?A: Form F-12 restricts the use and disclosure of protected health information by healthcare providers or organizations.
Form Details:
- Released on July 1, 2013;
- The latest edition provided by the Wyoming 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 F-12 by clicking the link below or browse more documents and templates provided by the Wyoming Department of Health.
