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Get the free DOH-5132OA. SPARCS/PRI Identifying Data Request Form - health ny

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NEW YORK STATE DEPARTMENT OF HEALTH Office of Quality and Patient Safety SPARKS Limited and Identifiable Data Request Organizational Affidavit STATE OF: FOR NYS DOH USE ONLY: COUNTY OF: Request Number
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The doh-5132oa sparcspri identifying data includes information to identify individuals related to healthcare services or research.
Healthcare providers and researchers are required to file doh-5132oa sparcspri identifying data.
The doh-5132oa sparcspri identifying data should be filled out accurately and completely following the instructions provided by the Department of Health.
The purpose of doh-5132oa sparcspri identifying data is to track and analyze healthcare services and research involving individuals.
Information such as name, date of birth, gender, medical history, and treatments received must be reported on doh-5132oa sparcspri identifying data.
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Relevant keywords

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