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File type: PDF
File page: 1 Page(s)
File size: 18KB
This Louisiana Authorization for Release of Protected Health Information possesses three sections. The first section is the part to inquire whether the patient would like to disclose the information. The second section is the release form, which contains the patient's personal information, release purpose, release content, and legal statement. And the last part is the signature. This file is offered for free. You can visit our website for it.
The Authorization to Release or Obtain Health Information of Louisiana Department of Health and Hospitals has two pages. The first page is the health information release form, and the second page is Important Information about Authorization, which illustrates the details of the form. And the form contains the patient's personal information, the releasing organization's information, the recipient's information, the purpose, the release content and the statement. Besides, this template is offered for free.
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