New York File Requisition Form

State:
New York
Control #:
NY-WCR-13
Format:
PDF
Instant download
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Public form

Description

File Requisition Form The New York File Requisition Form is a document required by the New York State Department of Health for requesting a copy of a person's medical records. It is used to provide proof of identity and to give authorization for the release of a person's medical information. There are two types of New York File Requisition Forms: the General File Requisition Form and the HIV/AIDS File Requisition Form. The General File Requisition Form is used to request medical records related to general health care, while the HIV/AIDS File Requisition Form is used to request records related to HIV testing and diagnosis. Both forms require the patient's name, date of birth, social security number, signature, and contact information. In addition, the HIV/AIDS File Requisition Form requires the patient's HIV test results.

The New York File Requisition Form is a document required by the New York State Department of Health for requesting a copy of a person's medical records. It is used to provide proof of identity and to give authorization for the release of a person's medical information. There are two types of New York File Requisition Forms: the General File Requisition Form and the HIV/AIDS File Requisition Form. The General File Requisition Form is used to request medical records related to general health care, while the HIV/AIDS File Requisition Form is used to request records related to HIV testing and diagnosis. Both forms require the patient's name, date of birth, social security number, signature, and contact information. In addition, the HIV/AIDS File Requisition Form requires the patient's HIV test results.

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New York File Requisition Form