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Authorization to Use and Disclose Protected Health Information (PHI) - This authorization form will be used by our clients to initiate a request to have their PHI disclosed outside of HCA or between Programs with sensitive confidentiality requirements. PHI Form in PDF PHI Form in Word

PHI Form in PDF PHI Form in Word

PHI Form in PDF PHI Form in Word

PHI Form in PDF PHI Form in Word

Revocation of Authorization Form in PDF