Sample HIPAA Authorization Form

Public Defender Services

This government document is issued by Public Defender Services for use in West Virginia

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File Details: DOC (59 KB)
Source
https://www.google.com/url?client=internal-element-cse&cx=007317577438028001491:vu-dvc_8do8&q=https://pds.wv.gov/community-resources/Documents/Fillable%2520HIPAA%2520Authorization%2520Form%2520typable.doc&sa=U&ved=2ahUKEwjY98XTm4CQAxVpdqQEHaQxNjgQFnoECAkQAQ&usg=AOvVaw0L22s0AcXMH0ojB2VwbulD

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