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Solicitud de Información de Salud de un Individuo - Request for an Individuals Health Information

Category:
Confidencialidad y no divulgación - Contratos - Información de salud protegida (HIPAA)
State:
Multi-State
Control #:
US-3577
Format:
Word
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Description

This form is used by an individual to request access to his or her protected health information. The individual's rights regarding this access are also acknowledged by the individual. 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.

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Solicitud de Información de Salud de un Individuo
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