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Veterans Administration Atlanta Veterans Affairs Medical CenterRevocation of Authorization for Release of Protected Health Information for Research VA Principal Investigators Name & full address (entered
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What is Revocation of Authorization for Release of Protected Health Ination for Research Form?

The Revocation of Authorization for Release of Protected Health Ination for Research is a fillable form in MS Word extension that should be submitted to the required address in order to provide specific information. It must be filled-out and signed, which may be done manually in hard copy, or with a certain solution like PDFfiller. It helps to complete any PDF or Word document directly in your browser, customize it according to your needs and put a legally-binding e-signature. Once after completion, you can easily send the Revocation of Authorization for Release of Protected Health Ination for Research to the relevant individual, or multiple individuals via email or fax. The template is printable as well from PDFfiller feature and options presented for printing out adjustment. In both electronic and physical appearance, your form will have a neat and professional appearance. You can also turn it into a template to use it later, without creating a new blank form from scratch. All that needed is to amend the ready sample.

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