199 results found

• 503 *50318* R Authorization to Use and Disclose Protected Health ...

  Mental Health Therapy Records. □ Operative report(s) ... Substance Use Disorder Treatment Record(s) ... Information Management/Medical Record Department.

• Patient and Family Rights

  medical record, in a timely fashion, and within the limits of the law. • To have all your child's personal and medical information and records kept confidential.

• Living Will and Durable Power of Attorney Idaho

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

• Making Choices® Releasing medical records. • Determining which ...

  What is a healthcare agent? A healthcare agent is a person chosen by a loved one, family member, or friend to make healthcare decisions, including end-.

• Title Substance Use Disorder NOTICE TO CLINIC STAFF AND ...

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

• Opioid Use in Pregnancy

  that weren't prescribed to patient. • Illegal (illicit) drug use. (street or recreational drugs). Check DOPL and medical records for patients with admitted / suspected ...

• Your Medicare Annual Wellness Visit brochure

  When you come in for your Medicare. Annual Wellness Visit, please bring the following: • Any medical records you have, including immunization records.

• Lumbar Spine

  Apr 9, 2013 ... Intermountain Healthcare 2013. Page 1 of 1. Patient Exam: Lumbar Spine Evaluation. Date: Time: Patient Name: M/F Age: Medical Record #:.

• Advance Care Planning Information

  your medical record is available. Treatment can be stopped if it is clear later that the treatment is not what you wanted. If you do not want CPR attempted, either.

• Back Pain

  Mar 8, 2013 ... Patient Self History: Back Pain. Date: Time: Patient Name (Last, First, MI). Date of Birth (MM-DD-YYYY). Medical Record # (for office use). 1.