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Colorado Authorization for Use and Disclosure of Health Information

State:
Colorado
Control #:
CO-9000R
Format:
Word; 
Rich Text
Instant download

Description

The authorization for release of information is signed by a patient of a medical or healthcar service provider. The form indicates the specific medical records to be released or disclosed and to whom the information should be released. It also contains an expiration date for the release. The release is given for a stated and specific purpose.
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How to fill out Colorado Authorization For Use And Disclosure Of Health Information?

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Colorado Authorization for Use and Disclosure of Health Information