Washington Sealed Personal Health Records Cover Sheet

• Category: Washington Local County - Whatcom - Superior Court
• State: Washington
• Control #: WA-SKU-1438
• Format: PDF

Description

Sealed Personal Health Records Cover Sheet Washington Sealed Personal Health Records Cover Sheet is a document used in the state of Washington to protect the privacy of a patient's Personally Identifiable Health Information (PHI). It is used to seal a patient's protected health information (PHI) from unauthorized access, and serves as a cover sheet for any sealed medical record or document sent by a healthcare provider. The Washington Sealed Personal Health Records Cover Sheet includes the patient's name, date of birth, and the medical record number. It also includes the name of the healthcare provider, the date of the request, and the reason for the request. There are two types of Washington Sealed Personal Health Records Cover Sheet — the original version and the revised version. The original version includes the patient's name, date of birth, and medical record number, as well as the name of the requesting physician, date of the request, and the reason for the request. The revised version includes additional information related to the request, such as the name of the recipient and the date on which the request was made. Both versions of the Washington Sealed Personal Health Records Cover Sheet must be signed by the patient or their designated representative in order to be valid.

Washington Sealed Personal Health Records Cover Sheet is a document used in the state of Washington to protect the privacy of a patient's Personally Identifiable Health Information (PHI). It is used to seal a patient's protected health information (PHI) from unauthorized access, and serves as a cover sheet for any sealed medical record or document sent by a healthcare provider. The Washington Sealed Personal Health Records Cover Sheet includes the patient's name, date of birth, and the medical record number. It also includes the name of the healthcare provider, the date of the request, and the reason for the request. There are two types of Washington Sealed Personal Health Records Cover Sheet — the original version and the revised version. The original version includes the patient's name, date of birth, and medical record number, as well as the name of the requesting physician, date of the request, and the reason for the request. The revised version includes additional information related to the request, such as the name of the recipient and the date on which the request was made. Both versions of the Washington Sealed Personal Health Records Cover Sheet must be signed by the patient or their designated representative in order to be valid.