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The sample HIPAA authorization form is a document that allows a person's protected health information to be disclosed to specific individuals or organizations.
Patients or individuals who wish to authorize the release of their protected health information are required to file the sample HIPAA authorization form.
The sample HIPAA authorization form must be filled out with the patient's personal information, the purpose of disclosure, specific information to be disclosed, and the expiration date of the authorization.
The purpose of the sample HIPAA authorization form is to protect the privacy of an individual's health information and to allow them to control who can access and disclose their medical records.
The sample HIPAA authorization form must include the patient's name, date of birth, specific information to be disclosed, expiration date of the authorization, and the names of the individuals or organizations authorized to receive the information.
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