Cook County Health HIPAA Authorization for Research

Provident Hospital of Cook County

This government document is issued by Provident Hospital of Cook County for use in Cook County, IL

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File Details: DOCX (43.8 KB)
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Source
https://cookcountyhealth.org/wp-content/uploads/Request-and-Authorization-to-Use-and-Disclose-Health-Information-For-The-Purpose-of-Research-Form-FINAL-8-14-2019.docx

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