Item #: 1679672 | Model #: DLF601-SL
Adams® HIPAA Authorization (Practice), 1-Use Interactive Digital Legal Form
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Adams® HIPAA Authorization (Practice), 1-Use Interactive Digital Legal Form

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$9.99
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Product Details
  • Lists person or persons allowed access to your health information, for an unlimited or designated time period
  • Specifies level of access to include or exclude mental health, addiction, or communicable disease treatment
  • Attorney-reviewed form valid for use in every state
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9.99
9.99
https://www.staples-3p.com/s7/is/image/Staples/m003904281
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Adams
Adams® HIPAA Authorization (Practice), 1-Use Interactive Digital Legal Form
Product Description
Adams Online Interactive forms let you instantly create high quality legal documents tailored to your needs. Powered by DirectLaw smart forms technology.

This form allows medical practitioners to help patients confidently create a HIPAA Authorization form to provide trusted family and friends access to their protected health information in the event of illness or incapacitation.

  • Lists person or persons allowed access to your health information, for an unlimited or designated time period
  • Specifies level of access to include or exclude mental health, addiction, or communicable disease treatment
  • Attorney-reviewed form valid for use in every state
  • Click the secure link in your email from Staples to begin the interactive Q&A that creates your legal form
  • Online Guidance Notes offer additional information on signing, filing, and executing your documents
  • Download to save and print your customized PDF file
  • This website provides legal forms only. We do not provide legal advice. Proper filing and service of documents and payment of related notary, court and filing fees are your responsibility. The legal documents offered from the web site are intended to be used within thirty (30) day from the time of purchase
  • Easy-to-follow questionnaire
  • After completing your on-line questionnaire, document is instantly availabl.
  • Download completed forms after online assembly
  • Web Browser: Microsoft Internet Explorer 7.0 or higher , Mozilla Firefox , Google Chrome , Safari 6.0 and earlier , Android Standard Browser
  • Print as many copies as you need
  • Step-by-step instructions included with your assembled form, help you to file or execute your documents correctly
  • Legal forms created by attorneys

This website provides legal forms only. We do not provide legal advice. Proper filing and service of documents and payment of related notary, court and filing fees are the responsibility of the purchaser. The legal documents offered from this website are intended to be used within thirty (30) days from the time of purchase.

Works with Microsoft Internet Explorer 7.0 or higher , Mozilla Firefox , Google Chrome, Safari 6.0 and earlier, and Android standard web browsers

Specifications
Legal Form Class Estate Planning
Legal Form Type Power of Attorney
Digital or Preprinted Form Digital Form
Pack Qty 1
Image File Formats PDF
Browser Microsoft Internet Explorer 7.0 or higher, Mozilla Firefox, Google Chrome, Safari 6.0 and earlier and Android standard web browsers
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