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Get Complete Authorization To Disclose Personal Health Information Form Online

L health information. Where to Return Your Completed Authorization Forms: After you complete and sign the authorization form, return it to the address below: Medicare BCC, Written Authorization Dept. PO Box 1270 Lawrence, KS 66044 For New York Medicare Beneficiaries ONLY The New York State Public Health Law protects information that reasonably could identify someone as having HIV symptoms or infection, and information regarding a person's contacts. Because of New York's laws protecting the priva.

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