Health Portability and Accounting Act (HIPAA)form that meets the Protected Health Information (PHI) requirements.
As required be the HIPAA, you must track to whom disclosures of PHI are made. This form, retained in each patient's medical record, includes the patient information that should be recorded when disclosures are made. This form will be photocopied for patients who request an "Accounting of Disclousure".
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