Skip Navigation
Add to wish list Shareable link
Roll on to zoom in
100%
Satisfaction
Guaranteed

We'll replace, credit, or refund your order, if you're not totally satisfied.

Learn More

HIPAA Patient Consent Auth For Release Of PHI

Item # 48945

4
local_shipping
Ready to Ship in 4 Business Days! details

As low as $45.69 each.

QuantityPrice EachTotal
1$45.69$45.69

Features

Use our HIPAA Patient Consent and Authorization for Release of PHI to meet your HIPAA obligations.

  • HIPAA requires health care providers and other covered entities to obtain an individual’s written authorization for any use or disclosure of protected health information (PHI) that is not for treatment, payment
  • or health care operations or otherwise permitted or required by the HIPAA Privacy Rule.
  • The form includes all HIPAA required elements that must be included in an authorization to make it valid.

Details

Product Size:
8.5" W x 11" H
Material:
Paper
Packaging:
200 forms per pack

Price Details

QuantityPrice EachTotal
1$45.69$45.69

We're sorry.

This coupon code has expired. For your convenience, we've applied a 20% OFF coupon on orders $150+.

Your new coupon code is:

Note: Coupon codes can be edited in the shopping cart.

 Chat Offline Form
EMAIL US

All agents are currently unavailable – but we still want to hear from you! Please email us and we will respond as quickly as possible. Thank you for your patience.

*
*
*
*

Your email has been sent. Thank you!