Other Uses and Disclosures Require Your Prior Written Authorization. In any other situation not described in Sections IIIA, IIIB, and IIIC above, I will request your written authorization before using or disclosing any of your PHI. Even if you have signed an authorization to disclose your PHI, you may later revoke that authorization, in writing, to stop any future uses and disclosures (assuming that I haven't taken any action subsequent to the original authorization) of your PHI by me.
Appears in 6 contracts
Samples: Agreement for Service / Informed Consent, Office Policies & General Information Agreement for Psychotherapy Services, Agreement for Service / Informed Consent
Other Uses and Disclosures Require Your Prior Written Authorization. In any other situation not described in Sections IIIA, IIIB, and IIIC above, I will request your written authorization before using or disclosing any of your PHI. Even if you have signed an authorization to disclose your PHI, you may later revoke that authorization, in writing, to stop any future uses and disclosures (assuming that I haven't taken any action subsequent to the original authorization) of your PHI by me.your
Appears in 1 contract
Samples: Professional Services
Other Uses and Disclosures Require Your Prior Written Authorization. In any other situation not described in Sections IIIA, IIIB, and IIIC above, I will request your written authorization before using or disclosing any of your PHI. Even if you have signed an authorization to disclose your PHI, you may later revoke that authorization, authorization in writing, writing to stop any future uses and disclosures (assuming that I haven't n’t taken any action subsequent to the original authorization) of your PHI by me.
Appears in 1 contract
Samples: Office Policies & General Information Agreement for Psychotherapy Services
Other Uses and Disclosures Require Your Prior Written Authorization. In any other situation not described in Sections IIIA, IIIB, and IIIC above, I we will request your written authorization before using or disclosing any of your PHI. Even if you have signed an authorization to disclose your PHI, you may later revoke that authorization, in writing, to stop any future uses and disclosures (assuming that I we haven't taken any action subsequent to the original authorization) of your PHI by meus.
Appears in 1 contract
Samples: Psychotherapy Agreement
Other Uses and Disclosures Require Your Prior Written Authorization. In any other situation not described in Sections IIIA, IIIB, and IIIC above, I we will request your written authorization before using or disclosing any of your PHI. Even if you have signed an authorization to disclose your PHI, you may later revoke that authorization, in writing, to stop any future uses and disclosures (assuming that I we haven't n’t taken any action subsequent to the original authorization) of your PHI by meus.
Appears in 1 contract
Samples: Psychotherapy Agreement
Other Uses and Disclosures Require Your Prior Written Authorization. In any other situation not described in Sections IIIAsections III A, IIIBB, and IIIC C above, I will request ask for your written authorization before using or disclosing any of your PHI. Even if If you have signed choose to sign an authorization to disclose your PHI, you may can later revoke that authorization, such authorization in writing, writing to stop any future uses and disclosures (assuming to the extent that I haven't taken any action subsequent to the original in reliance on such authorization) of your PHI by me.
Appears in 1 contract
Samples: Hipaa Notice of Privacy Practices