Cook County Health HIPAA Authorization for Research

Cermak Health Services of Cook County

This government document is issued by Cermak Health Services 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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