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Authorization for Release of Protected Health Information You may authorize Headfirst Blue Cross Bluesier in writing to share your health information with a third party such as an employer, lawyer,
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newauthrevised082003doc is a revised authorization document.
Entities who need to update their authorization information.
Fill out the form with accurate and updated information as per instructions provided.
The purpose is to ensure that authorization information is current and up to date.
Information such as contact details, authorization changes, and any relevant updates.
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