Disclosure of Health Information. Participant will only disclose or provide to the Network or its Subcontractors physical health, mental health, or behavioral health information, including substance use treatment information, about a Client if such disclosure or provision is in furtherance of the Permitted Use, as defined in the Participation Agreement, and only with written Authorization of the Client.
Disclosure of Health Information. Next Biosciences will maintain the confidentiality of my health information that I provide to them concerning myself and my Child. I do however understand that health care providers may need such information to provide treatment to me and/or my Child and/or matching relative and that government agencies may be entitled to obtain such information under applicable law and regulations. I authorize Next Biosciences to disclose such information to health care providers that are treating me and/or my Child and/or matching relative; and to government agencies as may be required under applicable law and regulations. I authorize Next Biosciences to disclose such information for research purposes in an anonymous manner and always maintaining Next Biosciences’ confidentiality obligations in terms hereof. If the Cord Blood that is collected has low cell count or low cell viability and is not recommended for Storage according to Next Biosciences storage limits and standards, I will be informed by Next Biosciences about the possible options available to me. I have the choice to continue Storage and will sign a disclaimer in order to do so, or if I decide to discontinue Storage I will sign a disclaimer to either donate the Cord Blood for internal research/ validation purposes or to discard it. Initial 3/4
Disclosure of Health Information. 9.1. Netcells, SABMR, Oncolab, SANBS and Ampath will maintain the confidentiality of my health information that I provide to them concerning myself, my family and my Child.
9.2. I do however understand that Healthcare Professionals may need such information to provide treatment to me and/or my Child and/or matching relative and that government agencies may be entitled to obtain such information under applicable law and regulations.
9.3. I authorize Netcells and SABMR to disclose such information to Healthcare Professionals that are treating me and/or my Child and/or matching relative and/or SABMR recipient; and to government agencies as may be required under applicable law and regulations.
9.4. I authorize Netcells and SABMR to disclose such information for research purposes in an anonymous and deidentified manner and always maintaining Netcells’ and SABMR’s confidentiality obligations in terms hereof.
Disclosure of Health Information. Netcells will maintain the confidentiality of my health information that I provide to them concerning myself and my Child. I do however understand that health care providers may need such information to provide treatment to me and/or my Child and/or matching relative and that government agencies may be entitled to obtain such information under applicable law and regulations. I confirm that I have read and accept Clause 11 and 12 of the Cord Blood/Tissue Storage and Related Services Agreement.
Disclosure of Health Information. Your health information may be used and disclosed without an authorization for the purposes listed below. The health information used or disclosed will be limited to the “minimum necessary,” as defined under the Privacy Rules. information with another entity to assist in the adjudication of reimbursement of your health claims.
Disclosure of Health Information. 12.1 The College’s policy is to protect a student’s privacy in relation to information about their health. Nevertheless, circumstances may arise where, in the College’s judgment, the best interests of the student require disclosure of information about their health to a parent or guardian.
12.2 You consent to the College contacting your parent(s) or guardian(s) if:
(a) you are involved in a medical emergency;
(b) you are admitted to hospital; or
(c) you display symptoms of a serious medical condition including a mental health condition.
Disclosure of Health Information. 9.1 Netcells, SANBS and Ampath will maintain the confidentiality of my health information that I provide to them concerning myself and my Child.
9.2 I do however understand that health care providers may need such information to provide treatment to me and/or my Child and/or matching relative and that government agencies may be entitled to obtain such information under applicable law and regulations.
9.3 I authorize Netcells to disclose such information to health care providers that are treating me and/or my Child and/or matching relative; and to government agencies as may be required under applicable law and regulations.
9.4 I authorize Netcells to disclose such information for research purposes in an anonymous manner and always maintaining Next Biosciences’ confidentiality obligations in terms hereof.
Disclosure of Health Information. Netcells, SANBS and Ampath will maintain the confidentiality of my health information that I provide to them concerning myself and my Child. I do however understand that health care providers may need such information to provide treatment to me and/or my Child and/or matching relative and that government agencies may be entitled to obtain such information under applicable law and regulations. I authorize Netcells to disclose such information to health care providers that are treating me and/or my Child and/or matching relative; and to government agencies as may be required under applicable law and regulations. I authorize Netcells to disclose such information for research purposes in an anonymous manner and always maintaining Next Biosciences’ confidentiality obligations in terms hereof. Initial 3/5
Disclosure of Health Information. I hereby authorize the Charity and any physician, health care professional, dentist, health plan, hospital, clinic, laboratory, pharmacy or other covered health care provider, any insurance company and the Medical Information Bureau Inc, or other health care clearinghouse that has provided or will provide treatment or services to the Individual, to share, give, disclose and release to the Charity or any third party provider, without restriction, all of the individual’s identifiable health information and medical records regarding any past, present or future medical or mental health condition. I intend this release to be treated as I would be treated with respect to my rights regarding the use and disclosure of the Individual’s identifiable health information and other medical records. This release authority applies to any information governed by the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), 42, U.S.C. 1320d and 45 C.F.R. 160 164. I certify that I have read this form or have had it read to me, that the blank spaces have been filled in and I understand it’s contents. I acknowledge that the volunteers, including but not limited to Maximum Chances, Inc. as well as technical assistants, physicians and health care providers are providing assistance that are not administered for or are in expectation of full cost compensation and the assistance are being provided in exchange for immunity from civil liability or limitations on the recovery of monetary damages for any act or omission resulting in death, damage or injury.
Disclosure of Health Information. I have been shown and offered a copy of the Kids’ RehabGYM Uses and Disclosure of Information Statement. I understand and accept the Kids’ RehabGYM HIPAA compliant policy and know that I can contact Xxxxxxx Xxxxxxxxxx (Executive Director) with any questions or concerns.
