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ORTHOPEDIC & TRAUMA SERVICES OF OKLAHOMA AUTHORIZATION FOR ACCESS BY PATIENT OR DISCLOSURE OF PROTECTED HEALTH INFORMATION Patient Name: First Middle Date of Birth Last Social Security Number I hereby
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A HIPAA-compliant release form is a document that allows the release of protected health information in accordance with the Health Insurance Portability and Accountability Act.
Healthcare providers, insurance companies, and other entities that handle protected health information are required to have individuals sign a HIPAA-compliant release form before disclosing their information.
To fill out a HIPAA-compliant release form, one must provide personal information, specify the information being released, and sign the document.
The purpose of a HIPAA-compliant release form is to ensure that patients' protected health information is disclosed only with their consent and in compliance with HIPAA regulations.
A HIPAA-compliant release form must include the individual's name, the information being disclosed, the purpose of the disclosure, and the expiration date of the authorization.
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