Medical and Tribal Information - Kansas
Medicare and Home Health Care
What's Medicare? What's Medicaid?
Form PPS5340 Medical and Genetic Information for Child - Kansas
Form CMS-855S Medicare Enrollment Application - Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (Dmepos) Suppliers
Formulario PPS5340 Informacion Medica Y Genetica Del Nino - Kansas (Spanish)
Form CMS-10106 Authorization to Disclose Personal Health Information Release Form
DD Form 877 Request for Medical/Dental Records or Information
Form PPS7240 Notice of Action - Medical Card Extension Program Eligibility Information - Kansas
DD Form 2871 Request to Restrict Medical or Dental Information
DA Form 4254 Request for Private Medical Information
DA Form 4876 Request and Release of Medical Information to Communications Media
VA Form 21-4142A General Release for Medical Provider Information to the Department of Veteran Affairs (VA)
Apendice 5Q Autorizacion Para Divulgar Informacion Incluida La Informacion De Salud Que Puede Establecer La Identidad De Los Ninos - Kansas (Spanish)
Form CMS-2744A End Stage Renal Disease Medical Information System Esrd Facility Survey (Dialysis Units Only)
Form CMS-2744B End Stage Renal Disease Medical Information System Esrd Facility Survey (Transplant Centers Only)
Apendice 5q - Autorizacion Para Divulgar Informacion Incluso Informacion Individual Identificable De Salud De Los Ninos - Kansas (Spanish)
Form CM-936 Authorization for Release of Medical Information (Black Lung Benefits)
Formulario CMS-10106 Formulario De Autorizacion Para Divulgar Informacion Medica Personal (Spanish)
Formulario PS6D Autorizacion Para Revelar Informacion Confidencial Programas De Tratamiento Para La Salud Mental (Spanish)
Form CMS-40B Application for Enrollment in Medicare Part B (Medical Insurance)
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