Item name: Authorization for use or Disclosure of Health Information
Page size: 8.5" x 11"
Document pages: 2
Language: English & Spanish
Description: Health Information Disclosure in English and Spanish. Patients must be assured that the health information they share with healthcare professionals will remain confidential. Without such assurance, patients may withhold critical information that could affect the quality and outcome of care.
Fully Editable: Easily modify forms to your office needs using Microsoft Word's editing tools, add your own practice company information, insert your practice logo, change/edit/add form fields, add images to your forms and print to any desktop printer to black & white or full color forms, print as needed and change forms as often as needed; forms completely modifiable to meet your exact practice needs.
For Use With: Form is compatible with Microsoft Word 97 and later versions for Windows version and Word for MAC 4.21 and later versions.
Software delivery: You will receive your software by e-mail link as soon as purchase is approved by online processor.
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