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Get Dhs 6241a Ncro. Request To Restrict Use And Disclosure Of Protected Health Informaiton By Parent

OR LEGAL REPRESENTATIVE File Number: You have the right to request the Department of Health Care Services (DHCS) to restrict the use and disclosure of the California Children s Services (CCS) protected health information to carry out treatment, payment or operations. You also have the right to request DHCS not to disclose CCS protected health information to a family member, relative, or friend involved with the care or payment of the individual s health care. DHCS may not.

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