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Get Permission To Verbally Discuss Protected Health Information With Family And Friends

Llows you to tell us who we may talk with about your health care. This includes appointment and scheduling information, lab and test results, treatment information and billing information. How can I give others permission to get verbal information about me? Complete the Permission to Verbally Discuss Protected Health Information form on the reverse side of this page to let us know to whom we may speak about your information. Check the appropriate boxes to indicate what information we may discuss.

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  1. Select the orange Get Form option to begin editing and enhancing.
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  5. Add the date to the record with the Date feature.
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  7. Make sure that every area has been filled in correctly.
  8. Click Done in the top right corne to save and send or download the document. There are various choices for receiving the doc. An attachment in an email or through the mail as a hard copy, as an instant download.

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