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Uf health authorization form

Uf protected 2025

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The document is a Record Request form that authorizes UF Health to use and disclose Protected Health Information (PHI) related to a patient. It outlines the necessary patient information, verification of identity, details about the representative if applicable, and specifies the types of medical records that may be released. The form also includes important legal disclaimers regarding the use of PHI, the patient's rights to revoke authorization, and potential fees for record requests.

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2015	4.8 Satisfied (164 Votes)

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