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Form 701P Accounting of Disclosures Request Form - Louisiana
What Is Form 701P?
This is a legal form that was released by the Louisiana Department of Health - a government authority operating within Louisiana. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 701P?
A: Form 701P is an Accounting of Disclosures Request Form.
Q: What is the purpose of Form 701P?
A: Form 701P is used to request information about the disclosures of your personal health information made by a healthcare provider.
Q: Who can use Form 701P?
A: Any individual can use Form 701P to request an accounting of disclosures.
Q: Is there a fee to submit Form 701P?
A: No, there is no fee to submit Form 701P.
Q: How should Form 701P be submitted?
A: Form 701P should be submitted to the healthcare provider that made the disclosures of your personal health information.
Q: Is Form 701P specific to Louisiana?
A: Yes, Form 701P is specific to Louisiana.
Form Details:
- Released on September 17, 2013;
- The latest edition provided by the Louisiana Department of Health;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form 701P by clicking the link below or browse more documents and templates provided by the Louisiana Department of Health.
Download Form 701P Accounting of Disclosures Request Form - Louisiana
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