Pittsburgh Pennsylvania Solicitud de Información de Salud de un Individuo - Request for an Individuals Health Information
State:
Multi-State
City:
Pittsburgh
Control #:
US-3577
Format:
Word
Instant download
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.
