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AUTHORIZATION TO USE AND DISCLOSE PROTECTED HEALTH INFORMATION Initial here if requesting information from Summerlin Hospital Medical Center. Note: There will be a charge of $.14 per page if source
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ri1001 - valley health is a form used for reporting health information related to Valley Health.
Certain health facilities and providers are required to file ri1001 - valley health.
ri1001 - valley health can be filled out electronically or manually following the instructions provided on the form.
The purpose of ri1001 - valley health is to gather health information specific to Valley Health for record-keeping and analysis.
Information such as patient demographics, medical conditions, treatments, and outcomes must be reported on ri1001 - valley health.
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