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State of California Health and Human Services Agency AUTHORIZATION FOR RELEASE OF PATIENT INFORMATION MH 5671 (Rev. 06/08) Page 1 of 3 Department of Mental Health Confidential Patient Information
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What is hippa form mh5671?
HIPAA Form MH5671 is a document used to report any breaches of protected health information.
Who is required to file hippa form mh5671?
Healthcare providers, health plans, and healthcare clearinghouses are required to file HIPAA Form MH5671.
How to fill out hippa form mh5671?
HIPAA Form MH5671 can be filled out online or submitted by mail. It requires detailed information about the breach of protected health information.
What is the purpose of hippa form mh5671?
The purpose of HIPAA Form MH5671 is to report breaches of protected health information and to ensure compliance with HIPAA regulations.
What information must be reported on hippa form mh5671?
HIPAA Form MH5671 requires information about the nature of the breach, the individuals affected, and the steps taken to mitigate the breach.
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