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AUTHORIZATION FOR USE OR DISCLOSURE OF
PROTECTED HEALTH INFORMATION (PHI)
Via Christi Clinic
Mail to: 1947 Founders Circle
Wichita, KS 67206
Or fax to the
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Visit the Via Christi Clinic website or go to the nearest clinic location.
03
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Review the filled-out forms for any errors or missing information.
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What is via christi clinic?
Via Christi Clinic is a healthcare facility that provides medical services to patients.
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Healthcare providers and facilities are required to file Via Christi Clinic.
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To fill out Via Christi Clinic, you need to provide accurate and detailed information about the medical services provided.
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The purpose of Via Christi Clinic is to ensure that patients receive quality medical care.
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