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San Francisco Department of Public Health (DPH) Full Notice of HIPAA Privacy Rights Effective Date: May 19, 2015, THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND SHARED BY

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This notice describes the process of filing a specific form or document.

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Any individual or entity who meets the criteria outlined in the instructions for the form.

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Follow the detailed instructions provided with the form, ensuring all required information is accurately and completely filled in.

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