Date: 2014-12-05 13:02:48Medicine United States Department of Veterans Affairs Government Healthcare in the United States Health Insurance Portability and Accountability Act Social Security number Veterans Health Administration Social Security Medical record Health Taxation in the United States Medical informatics | | OMB Number: Estimated Burden: 2 minutes REQUEST FOR AND AUTHORIZATION TO RELEASE MEDICAL RECORDS OR HEALTH INFORMATION Privacy Act and Paperwork Reduction Act Information: The execution of this form does not auDocument is deleted from original location. Use the Download Button below to download from the Web Archive.Download Document from Web Archive File Size: 355,86 KB
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