Healthcare Practice Forms and Supplies


	Your cart is empty.


	Email Address:

Authorization to Use of Disclosure Protected Health Information

Our Price: $21.85

Item Number: 18245

Quantity:

Add to a new shopping list

Email this page to a friend

Authorization to Use of Disclosure Protected Health Information
HIPAA "Authorization to use of disclosure protected health information" form complies with HIPAA standard privacy security transactions. Printed on one side 20 lb. white stock black ink. Two drill holes on top. 200 forms per package. Overall size 8-1/2" W x 11" H.

SKU: 18245
Unit of Measure: PCKG
Color: White
Size: 8-1/2" W x 11" H
Quantity: 200/Pkg