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HC 936 Radiology Preg Release PDF University of California, Santa Shs Manual Ucsc  Form

HC 936 Radiology Preg Release PDF University of California, Santa Shs Manual Ucsc Form

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What is the HC 936 Radiology Preg Release PDF from the University of California, Santa Cruz?

The HC 936 Radiology Preg Release PDF is a specialized form used by the University of California, Santa Cruz (UCSC) to facilitate the release of medical information related to radiology for pregnant individuals. This document is essential for ensuring that the necessary medical data is shared appropriately while maintaining patient confidentiality. It is often required for medical evaluations, consultations, or treatment plans involving radiological services.

How to Use the HC 936 Radiology Preg Release PDF

Using the HC 936 Radiology Preg Release PDF involves several straightforward steps. First, download the form from the UCSC health services website or obtain it directly from the relevant department. Once you have the form, fill in the required personal information, including your name, date of birth, and contact details. Ensure that all sections are completed accurately to avoid delays in processing. Finally, sign and date the form before submitting it to the designated office.

Steps to Complete the HC 936 Radiology Preg Release PDF

Completing the HC 936 Radiology Preg Release PDF requires careful attention to detail. Follow these steps:

  • Download the form from the UCSC website.
  • Fill in your personal information accurately.
  • Provide details about the specific radiology services requested.
  • Review the form for completeness and accuracy.
  • Sign and date the form.
  • Submit the completed form to the appropriate UCSC office.

Legal Use of the HC 936 Radiology Preg Release PDF

The HC 936 Radiology Preg Release PDF is legally binding when completed and signed according to the guidelines set forth by UCSC. It complies with federal and state regulations regarding medical records and patient privacy, including HIPAA. This ensures that the information shared through this form is protected and used solely for the intended medical purposes.

Key Elements of the HC 936 Radiology Preg Release PDF

Key elements of the HC 936 Radiology Preg Release PDF include:

  • Patient identification information, such as name and date of birth.
  • Details regarding the specific radiology services being requested.
  • Authorization for the release of medical information.
  • Signature of the patient or authorized representative.
  • Date of signature to establish the timeline of consent.

Examples of Using the HC 936 Radiology Preg Release PDF

Examples of scenarios where the HC 936 Radiology Preg Release PDF may be used include:

  • A pregnant patient needing an ultrasound for diagnostic purposes.
  • A healthcare provider requesting access to a patient's previous radiology reports.
  • Coordination of care between different medical specialists involved in a patient's treatment.

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