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Form RSA-1312A-LP Authorization for Disclosure of Health Information to Rsa - Large Print - Arizona
What Is Form RSA-1312A-LP?
This is a legal form that was released by the Arizona Department of Economic Security - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the RSA-1312A-LP form?A: The RSA-1312A-LP form is an Authorization for Disclosure of Health Information in large print.
Q: What is the purpose of the RSA-1312A-LP form?A: The purpose of the form is to authorize the disclosure of health information.
Q: Who is the intended recipient of the RSA-1312A-LP form?A: The form is intended for Rsa in Arizona.
Q: What does "LP" stand for in RSA-1312A-LP?A: LP stands for large print.
Q: What type of information can be disclosed with this form?A: The form allows for the disclosure of health information.
Form Details:
- Released on September 1, 2022;
- The latest edition provided by the Arizona Department of Economic Security;
- 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 RSA-1312A-LP by clicking the link below or browse more documents and templates provided by the Arizona Department of Economic Security.
Download Form RSA-1312A-LP Authorization for Disclosure of Health Information to Rsa - Large Print - Arizona
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