151 results found

• * 503 *50318* R

  Information Management/Medical Record Department. If I revoke this Authorization, Intermountain Healthcare may not be able to reverse the use of disclosure ...

• Making Choices®

  Releasing medical records. • Determining which organization and healthcare professional should provide care. You have been chosen by.

• Patient and Family Rights

  physician, to accept or refuse medical care as ... medical record, in a timely fashion, and within the ... information and records kept confidential.

• Title Substance Use Disorder

  NOTICE TO CLINIC STAFF AND MEDICAL RECORDS:The information on this page is protected by special federal confidentiality rules (42 CFR Part 2), ...

• Opioid Use in Pregnancy

  ENSURE patient understands that prescription medications can be misused, just like “street” drugs (see the ... Check DOPL and medical records for patients.

• Living Will and Durable Power of Attorney for Health Care

  medical records. This release authority applies to any information governed by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 42.

• Your Medicare Annual Wellness Visit

  or delay medical problems. Getting ... This information is not a substitute for professional medical advice, ... Any medical records you have, including.

• 50183

  Intermountain Healthcare 2013. Page 1 of 1. Patient Exam: Lumbar Spine Evaluation. Date: Time: Patient Name: M/F Age: Medical Record #:.

• 50043

  medical record(s), and/or consulting with family members and/or other ... Purpose: This tool enables you to estimate the patient's suicide risk through ...

• 50250

  Patient Self History: Back Pain. Date: Time: Patient Name (Last, First, MI). Date of Birth (MM-DD-YYYY). Medical Record # (for office use).