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Authorization for Disclosure of Protected Health information4450 31st Ave S. Suite 102 Fargo, ND 58104 Phone: 7012802033 Fax: 7012325578 Email: info healthcare.constructions: Fill out each section
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Contact usima healthcare is a form of communication with the healthcare provider regarding medical treatment or services.
Individuals who have received medical treatment or services from usima healthcare are required to file contact usima healthcare.
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The purpose of contact usima healthcare is to facilitate communication between the healthcare provider and the individual regarding medical treatment or services.
Information such as personal details, medical treatment received, health insurance information, and any other relevant details must be reported on contact usima healthcare.
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