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Release of Information
Adult Proxy Access to MyChart by Adult
Authorization for Access by Hospital Education
Authorization for Release of Medical Information
Authorization for Sharing of Information: Patient to Patient
Custody - Managing Peds Custody Docs SW.pdf
Non-HIS Preapproved Release of Information Scenarios/0340
Obtaining Copies of Your Medical Record
Parent_Legal Guardian_Other Adult Proxy Access to Adolescent MyChart (Child aged 13-17 Yrs old)
Parent/Legal Guardian Proxy Access to MyChart (Child under 13 Yrs Old)
Parent/Legal Guardian Proxy Access to MyChart (Child under 13 Yrs Old)Spanish)
Parent/Legal Guardian_Other Adult Proxy Access to Adolescent MyChart ( Child aged 13-17 Yrs Old/Spanish)
Proxy Access to My Chart for Caregivers
Proxy Access to My Chart for Caregivers(Spanish)
Request for Amendment of Health Information
Request for an Accounting of Disclosures
Request for Medical Records (non-patient care purposes)
Request for Non-Disclosure of Health Information to Health Plan
Request for Restriction on Uses & Disclosures of Health Information
Sensitive Notes, Open Notes, BTG...
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