PS 16-2: Request for Access to Personal Health Care Information (PHI): DES Authorization to Release Information
Date:
Note that as of July 8, 2019, DES has a new Authorization to Release Information form, https://www.masslegalservices.org/content/des-authorization-release-information.
Prior version, July 21, 2016.
| Attachment | Size |
|---|---|
| PS 2016-2 8.5.19 Rev. - DES Authorization to Release Protected Health Information.docx (29.89 KB) | 29.89 KB |
| PS 16-2 DES Authorization to Release Protected Health Information.docx (31.7 KB) | 31.7 KB |
| DES - Autho to Release Info 11-1-16.docx (50.11 KB) | 50.11 KB |