This form is used to authorize the company to obtain results of an employee's drug or alcohol tests or other medical tests.
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.California Autorización para la divulgación de información médica - California Authorization for Disclosure of Medical Information
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How to fill out California Autorización Para La Divulgación De Información Médica?
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Autorización para divulgar información médica de HIPAA para NYCHHC. Documentación que pueda indicar la presencia de enfermedades transmisibles o venéreas entre las que se incluyen enfermedades como la hepatitis, sífilis,.Utilice este formulario para autorizar a Health Partners Plans a usar su información médica o divulgarla a otra persona u organización.