Get the free doh 2557 2011-2019 form

Description of doh 2557
If releasing only non HIV related health information you may use this form or another HIPAA compliant general health release form. DOH 2557 2/11 Page 1 of 3 Complete information for each facility/person to be given general information and/or HIV related information. Attach additional sheets as necessary. Authorization for Release of Health Information and Confidential HIV Related Information New York State...
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doh 2557
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NY DOH-2557 Form Versions

Version Form Popularity Fillable & printable
NY DOH-2557 2011 4.9 Satisfied
(483 Votes)
NY DOH-2557 2005 4.0 Satisfied
(52 Votes)