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Privacy Rule
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HIPAA Forms:
Accounting for Disclosures (ODM 03398)
Authorization (ODM 03397)
CDJFS Authorization Template (
PDF format
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MS Word
) Note to CDJFS: Please use this template and not the ODM Authorization form. When using the Word format, save to your local drive and modify for your agency's use.
Amendment to PHI (ODM 01952)
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