Release of Medical Information. As a condition to the receipt of Plan benefits, each Covered Person authorizes Company to use and obtain information about his or her medical history, medical condition and the Services provided to him or her as may be necessary in connection with the administration of this Agreement. Information from medical records of Covered Persons and information received from Physicians or Hospitals arising from the Physician-patient relationship shall be kept confidential and shall only be disclosed with the consent of the Covered Person and in accordance with applicable law.
Release of Medical Information. The facility-provider of service shall submit on a periodic basis, or at the request of the employee, Director of Human Resources or EAP Coordinator, the following information concerning the employee's progress: - The nature and duration of the treatment; - Progress reports as to the employee's status in the program This information is confidential and shall be released by the facility-provider of service only to the Director of Human Resources, EAP Coordinator and representative designated by the Union for such purpose.
Release of Medical Information. The Employer may require the Employee to consent to the release any medical information gathered during a medical examination undertaken pursuant to this clause.
Release of Medical Information. The privacy of all residents will be protected as provided for by The Health Insurance Portability and Accountability Act and other applicable regulations. Resident hereby authorizes Willow Valley to release any medical information in printed or electronic formats relating to Resident to any doctor, hospital, or other environment or individuals when it is deemed necessary or helpful in providing for Resident’s ongoing care or treatment or for the purpose of submitting claims for benefits payable for Supportive Living services. Resident further authorizes the release of any information to Willow Valley from any Supportive Living services provider when deemed necessary or beneficial for providing for Resident’s ongoing care or treatment.
Release of Medical Information. Resident consents to the release of medical information to Xxxxxx Lakeside at Reeds Landing by any physician, hospital, or other health care provider. Resident also agrees to the release of medical information by Xxxxxx Lakeside at Reeds Landing to the providers listed above.
Release of Medical Information. The State of California Information Practices Act requires UBCP to provide the following information to individuals who supply information about themselves. As a patient of UBCP, I will be asked to submit certain personal information, such as my address and phone number, Social Security number, insurance information, medical history and treatment. The principal purpose for requesting this information is to ensure accurate identification, continuity of medical care, and payment for such care. Under the authority of The Federal Privacy Act of 1974, Article IX, Section 9 of the California Constitution, the California Information Practices Act (Civil Code 1798 et seq.), California Code of Regulations, Title 22, Section 70749, UBCP is authorized to maintain this information. As required by UBCP, furnishing all information requested is mandatory unless otherwise noted. I understand that failure to provide such information may affect my medical care and/or insurance benefits and coverage. UBCP will obtain my written authorization to release information about my medical treatment, except in those circumstances when UBCP is permitted or required by law to release information (see UBCP's Notice of Privacy Practices for a description of the specific circumstances under which UBCP may release this information). For example, UBCP may release a copy of my patient record to health care providers, health plans, governmental agencies and workers' compensation carriers. Additionally, I understand that if I am diagnosed with a reportable disease in California, UBCP is required by law to report my diagnosis to the State Department of Health Services.
Release of Medical Information you agreeing (by signing and returning this Contract) to the release and use of your medical records, including your past injury, illness and rehabilitation history and information resulting from the medical examination under paragraph (b) below, to the NZRU (and any third party as necessary) for the purpose of the medical assessment under paragraph (b) below;
Release of Medical Information. Resident consents to the release of medical information to Xxxxxx Village by any physician, hospital, or other health care provider. Resident also agrees to the release of medical information by Xxxxxx Village to the providers listed above and to Xxxxxx Nursing Center. Xxxxxx Village complies with all applicable requirements regarding maintaining protected health information.
Release of Medical Information. I authorize the doctors of Advanced Orthopedic Center to release any information concerning my care to my insurance company. I also authorize the release of information to any agency necessary for the payment on my account. I authorize Advanced Orthopedic Center to release/obtain records to/from any doctor and/or medical facility that they may deem pertinent to my care.
Release of Medical Information. I authorize the release of any and all information pertinent to my case to any insurance company, adjuster, or attorney involved in this case who makes the request in writing. Further, I authorize the release of my medical information to my personal or referral physician.
