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Mr1470 Form

Mr1470 Form

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What is the MR1470?

The MR1470 is a specific form used in Oregon related to the management and sharing of health information. This form is particularly relevant for individuals seeking to authorize the release of their medical records from Oregon Health & Science University (OHSU). It serves as a formal request that allows patients to control who has access to their personal health information, ensuring compliance with privacy regulations.

How to Use the MR1470

Using the MR1470 involves filling out the form accurately to ensure that your health information is shared correctly. Start by providing your personal details, including your full name, date of birth, and contact information. Specify the type of information you wish to share, such as medical records or treatment history. Finally, indicate the recipient of this information, whether it is a healthcare provider or another authorized individual.

Steps to Complete the MR1470

Completing the MR1470 requires careful attention to detail. Follow these steps:

  • Obtain the MR1470 form from OHSU or download it from their website.
  • Fill in your personal information accurately, including your name and contact details.
  • Clearly indicate the specific health information you wish to disclose.
  • Identify the person or organization to whom you are granting access.
  • Sign and date the form to validate your request.

Legal Use of the MR1470

The MR1470 is legally binding when completed correctly. It complies with federal and state regulations that govern the privacy of health information, such as HIPAA. By signing this form, you are granting permission for your health information to be shared, which must be respected by the receiving party. Understanding the legal implications ensures that your rights are protected while allowing necessary access to your medical records.

Key Elements of the MR1470

Several key elements must be included in the MR1470 for it to be valid:

  • Patient Identification: Full name, date of birth, and contact information.
  • Information to be Released: Specific details about the health information being shared.
  • Recipient Information: Name and contact details of the person or organization receiving the information.
  • Signature and Date: The patient's signature and the date of signing, which confirms consent.

How to Obtain the MR1470

The MR1470 can be obtained directly from OHSU facilities or through their official website. Patients may also request a copy by contacting OHSU’s medical records department. It is important to ensure that you have the most current version of the form to avoid any issues during the submission process.

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