![Healthcare in the United States / Blue Cross Blue Shield Association / Privacy law Healthcare in the United States / Blue Cross Blue Shield Association / Privacy law](https://www.pdfsearch.io/img/c090d47ef2edc9fa28b85a194e4e1765.jpg) Date: 2012-08-28 10:14:19Healthcare in the United States Blue Cross Blue Shield Association Privacy law | | TYSON PERSONAL REPRESENTATIVE APPOINTMENT AND AUTHORIZATION TO RELEASE PROTECTED HEALTH INFORMATION This form is used to authorize Wellmark to disclose protected health information at the request of the individual. INDIVAdd to Reading ListSource URL: www.wellmark.comDownload Document from Source Website File Size: 131,45 KBShare Document on Facebook
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