![Primary care / Social Security number / Health / Privacy / Internet privacy / Social Security / Medicine / Health Insurance Portability and Accountability Act / Patient safety / Taxation in the United States / Ethics / Health care Primary care / Social Security number / Health / Privacy / Internet privacy / Social Security / Medicine / Health Insurance Portability and Accountability Act / Patient safety / Taxation in the United States / Ethics / Health care](https://www.pdfsearch.io/img/586763fc1c2d9b6b57b403127acdea16.jpg) Date: 2010-04-30 14:27:19Primary care Social Security number Health Privacy Internet privacy Social Security Medicine Health Insurance Portability and Accountability Act Patient safety Taxation in the United States Ethics Health care | | PRIVACY ACT STATEMENT - HEALTH CARE RECORDS THIS FORM IS NOT A CONSENT FORM TO RELEASE OR USE HEALTH CARE INFORMATION PERTAINING TO YOU. 1. AUTHORITY FOR COLLECTION OF INFORMATION INCLUDING SOCIAL SECURITY NUMBER (SSN) S
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