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ACM Psychiatric Consultants, LLC 4740 Flint ridge Drive, Suite 214 Colorado Springs, CO 80918 P: (719) 3577617 F: (719) 3442311 ACKNOWLEDGEMENT OF RECEIPT OF PRIVACY PRACTICES I, acknowledge that
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The HIPAA Privacy Form-1116135254 is a form used to report any breaches of protected health information.
Covered entities and business associates are required to file the HIPAA Privacy Form-1116135254.
The HIPAA Privacy Form-1116135254 must be filled out by providing detailed information about the breach, including when it occurred, who was affected, and what steps are being taken to mitigate the damage.
The purpose of the HIPAA Privacy Form-1116135254 is to ensure that breaches of protected health information are properly reported and addressed.
Information such as the date of the breach, the type of information breached, the number of individuals affected, and any actions taken to address the breach must be reported on the HIPAA Privacy Form-1116135254.
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