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Get Pa Faculty Health And Welfare Fund Benefits - West Chester University

D to use or disclose your Protected Health Information to someone other than you, you must complete this Authorization Form and return it to the Fund. Protected Health Information ( PHI ) is information that is created, received, transmitted or stored by the Fund relating to your past, present or future physical or mental health, health care or payment for health care, and either identifies you or provides a reasonable basis for identifying you. Except as permitted by law, the Fund may not u.

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