Newark New Jersey Children's Hospital Health Information Exchange Patient Authorization

State:
Multi-State
City:
Newark
Control #:
US-70405NMS
Format:
Word; 
Rich Text
Instant download

Description

An authorization allowing a Children's Hospital to access your information and when necessary share your information with other providers through a Health Information Exchange (HIE) that expires in 1 year from the date of your signature.
Free preview
  • Form preview
  • Form preview

Trusted and secure by over 3 million people of the world’s leading companies

Newark New Jersey Children's Hospital Health Information Exchange Patient Authorization