Disclaimer: We request that you do not provide any protected health information when submitting your completed form as such disclosure by you may not be protected by federal privacy laws or regulations.
1 45 C.F.R. § 160.103.
Disclaimer: We request that you do not provide any protected health information when submitting your completed form as such disclosure by you may not be protected by federal privacy laws or regulations.
1 45 C.F.R. § 160.103.