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Form Approved: OMB # 09380948Office of Health Standards and Services (LESS) HIPAA Privacy Complaint Form IMPORTANT: The information requested in the remainder of this form is optional. However, any additional
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Form approved OMB 0938-0948 is a specific form used for reporting certain information to the Office of Management and Budget.
Individuals or entities designated by the Office of Management and Budget are required to file form approved OMB 0938-0948.
Form approved OMB 0938-0948 must be filled out by providing the required information in the designated fields on the form.
The purpose of form approved OMB 0938-0948 is to collect specific data and information for regulatory or analytical purposes.
Form approved OMB 0938-0948 requires reporting of detailed information as specified by the Office of Management and Budget.
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