Form 6700 Use and Release of Health Information Authorization - Texas
Authorization to Release Medical Records
Authorization for Medical Treatment, and Waiver and Release of Claims, for Minor Participant of: Civil Air Patrol National Cadet Competition
Authorization to Use and Disclose Protected Health Information - Williamson County, Texas
Form 2076 Authorization to Release Medical Information - Texas
Form 5025 Authorization for Use and Release of Health Insurance Information - Texas
Form 3039 Authorization to Disclose Protected Health Information - Texas
Form H2076 Authorization to Release Medical Information - Texas
Form CM-936 Authorization for Release of Medical Information (Black Lung Benefits)
Form TRS628 Authorization for Use or Disclosure of Protected Health Information - Texas
Form 2200-CD Authorization to Release Medical Information - City of Austin, Texas (English/Spanish)
Form IHS-810 Authorization for Use or Disclosure of Protected Health Information
VA Form 0857K Authorization for Limited Release of Medical Information
Form CMS-10106 Authorization to Disclose Personal Health Information Release Form
NOAA Form 56-67 Authorization for Release of Medical Records (From CPC)
Form CP-EMS-002 Authorization to Use/Disclose Protected Health Information - City of Dallas, Texas
Formulario 2870-S Autorizacion Para Divulgar Informacion Medica Protegida Y Otra Informacion Confidencial - Texas (Spanish)
Formulario CMS-10106 Formulario De Autorizacion Para Divulgar Informacion Medica Personal (Spanish)
AF IMT Form 786 Patient's Authorization for Release of Medical Information
VA Form 10-0459 Credentialing Release of Information Authorization
Government Agency Request for Release of Private & Protected Health Information (Pphi) - City of Dallas, Texas
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