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AUTHORIZATION TO USE OR DISCLOSE PROTECTED HEALTH INFORMATION Patients Name:DOB:Last four of SSN:City:State:Zip:Patients Street Address: 1.Apt/Unit #:___AUTHORIZED PERSONS TO USE AND DISCLOSE PROTECTED
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What is how we may use?
How we may use is a form or document that outlines the acceptable ways in which a particular item or service can be utilized.
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Individuals or organizations who are in possession of an item or providing a service that has specific guidelines on its use may be required to file how we may use.
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