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AUTHORIZATION FOR RELEASE OF PROTECTED HEALTH INFORMATION (PHI) JFK Medical Center Fax: 855-668-0697 Phone: 888-616-5721 Section A: This section must be completed for all Authorizations Patient Name:
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What is authorization for release of?
Authorization for release of is a legal document that allows someone to release information about someone else to a third party.
Who is required to file authorization for release of?
Authorization for release of must be filed by the individual whose information is being released.
How to fill out authorization for release of?
Authorization for release of can be filled out by providing the required information such as name, date of birth, and the specific information being released.
What is the purpose of authorization for release of?
The purpose of authorization for release of is to allow individuals to give permission for their information to be shared with others.
What information must be reported on authorization for release of?
Information that must be reported on authorization for release of includes the name of the individual authorizing the release, the specific information being released, and the recipient of the information.
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