AuthorizAtion for use or Disclosure of heAlth informAtion

HERITAGE AND CULTURE Presentacion

HERITAGE AND CULTURE Presentacion

Authorization for Use or Disclosure of Health Information

Authorization for Use or Disclosure of Health Information

Celebrando la Herencia Hispana

Celebrando la Herencia Hispana

Page 1 FINANCIAL RESPONSIBILITY AND AUTHORIZATION TO

Page 1 FINANCIAL RESPONSIBILITY AND AUTHORIZATION TO

LOWER RIO GRANDE PUBLIC WATER WORKS AUTHORITY

LOWER RIO GRANDE PUBLIC WATER WORKS AUTHORITY

Medical Records Release and Authorization Autorización para

Medical Records Release and Authorization Autorización para

540‐542 East 180th Street, Suite 101 Bronx NY

540‐542 East 180th Street, Suite 101 Bronx NY

Conceptos generales

Conceptos generales

ANANSI CHARTER SCHOOL - McCurdy Charter School

ANANSI CHARTER SCHOOL - McCurdy Charter School

Document

Document