Release of Information to Family/Friends. Our organization may release your identifiable health information to a friend or family member who is helping you pay for your health care of who assists in taking care of you.
Appears in 3 contracts
Samples: Authorization for Release of Information, Assignment of Benefits, Duplicate Equipment/Supplies, Authorization for Release of Information, Assignment of Benefits, Duplicate Equipment/Supplies, Authorization for Release of Information, Assignment of Benefits, Duplicate Equipment/Supplies
Release of Information to Family/Friends. Our organization may release your identifiable protected health information to a friend or family member who is helping you pay for your health care of who assists in taking care of you.
Appears in 2 contracts
Samples: Customer Information Agreement, Customer Information Checklist
