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HIPAA ACKNOWLEDGMENT AND CONSENT I understand that by signing this consent I authorize Debra O'Brien, LCSW to use and disclose certain health information about me to consult with my Primary Care Provider
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The HIPAA acknowledgment form is a document that individuals sign to acknowledge their understanding of the HIPAA privacy rules.
Anyone who handles protected health information (PHI) in a healthcare setting is required to file the HIPAA acknowledgment form.
To fill out the HIPAA acknowledgment form, individuals must read and understand the privacy rules outlined in the document, then sign and date it.
The purpose of the HIPAA acknowledgment form is to ensure that individuals understand their responsibilities when handling PHI and to protect the privacy of patients.
The HIPAA acknowledgment form typically requires individuals to provide their name, job title, contact information, and signature.
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