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P E D I AT R I C T H E RA P PATIENT DISCLOSURE AUTHORIZATION FORM Patient Name: Date of Birth: I authorize disclosure of my children protected health information only in the specific manner, for the
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Various individuals may need to fill out p e d i for different purposes including:
1. Individuals applying for a travel visa or work permit.
2. Students applying for educational programs abroad.
3. Individuals seeking immigration or residency status in a foreign country.
4. Employers sponsoring employees for work-related purposes.
5. Individuals applying for citizenship or naturalization.
6. People involved in legal proceedings across borders.
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What is p e d i?
PEDI stands for Post Employment Data Intermediation.
Who is required to file p e d i?
Employers are required to file PEDI for their employees.
How to fill out p e d i?
PEDI can be filled out online through the designated portal provided by the authorities.
What is the purpose of p e d i?
The purpose of PEDI is to collect and organize post-employment data for regulatory and statistical purposes.
What information must be reported on p e d i?
Information such as employee name, social security number, date of termination, reason for termination, and final salary must be reported on PEDI.
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