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Form MO375-0195 Uniform Complaint (With HIPAA Authorization) - Missouri
What Is Form MO375-0195?
This is a legal form that was released by the Missouri Division of Professional Registration - a government authority operating within Missouri. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the purpose of Form MO375-0195?
A: Form MO375-0195 is used to file a uniform complaint in Missouri.
Q: What is a uniform complaint?
A: A uniform complaint is a formal complaint that can be filed by individuals or organizations regarding various issues.
Q: What is HIPAA?
A: HIPAA stands for Health Insurance Portability and Accountability Act, which protects the privacy and security of health information.
Q: Why is HIPAA authorization included in this form?
A: HIPAA authorization is included in this form to allow the release of protected health information related to the complaint.
Q: Who can file Form MO375-0195?
A: Any individual or organization with a complaint related to the jurisdiction of the Missouri Department of Insurance, Financial Institutions, and Professional Registration can file this form.
Form Details:
- Released on June 1, 2022;
- The latest edition provided by the Missouri Division of Professional Registration;
- 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 MO375-0195 by clicking the link below or browse more documents and templates provided by the Missouri Division of Professional Registration.
Download Form MO375-0195 Uniform Complaint (With HIPAA Authorization) - Missouri
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