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VALLE VISTA HEALTH SYSTEM

VALLE VISTA HEALTH SYSTEM 2025

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The document is an authorization form for the use or disclosure of health information, specifically regarding medical, psychiatric, and substance abuse records. It outlines the legal protections under federal confidentiality rules, details the recipient's information, specifies what health records can be shared, and states the purpose of the disclosure. The form also includes information about charges for copies, expiration of authorization, rights of the patient, and requirements for signatures.

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