AUTHORIZATION FOR DISCLOSURES OF HEALTH INFORMATION Patient Name: ________________________________________________DOB: _____________MR__________________ I hereby authorize Western Maryland Health System the use or disclo - WMHS - Document - PDFSEARCH.IO

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	AUTHORIZATION FOR DISCLOSURES OF HEALTH INFORMATION Patient Name: ________________________________________________DOB: _____________MR__________________ I hereby authorize Western Maryland Health System the use or disclo Add to Reading List Document Date: 2012-05-25 14:56:12 Open Document File Size: 274,07 KB Share Result on Facebook City Photo / / IndustryTerm mental health services / / MedicalCondition sexually transmitted disease / HIV / drug abuse / / Person Records Emergency / / Position patient/representative / Attorney / / Region Western Maryland / / SocialTag Law Data privacy Health Insurance Portability and Accountability Act Privacy law Medical record Freedom of information legislation Medical informatics Health Medicine

AUTHORIZATION FOR DISCLOSURES OF HEALTH INFORMATION Patient Name: ________________________________________________DOB: _____________MR__________________ I hereby authorize Western Maryland Health System the use or discloAdd to Reading List