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New Mexico HIPAA Release Form

New Mexico HIPAA Release Form

Use a New Mexico HIPAA Release Form template to make your document workflow more streamlined.

HSD HIPAA Privacy Officer PO Box 2348 Santa Fe NM 87504-2348 Phone 1-888-997-2583. I understand that if I do not specify an expiration date this authorization will expire six months from the date on which it was signed. I have read and understand the Important Information about Authorization contained on the back of this page. Further Medical Care Personal Legal Investigation or Action Changing Medical Providers Participation in Research Study Marketing Creating Health Information for...
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