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This version of the form is not currently in use and is provided for reference only. Download this version of
Form WCB-220-C
for the current year.
Form WCB-220-C Limited Release of Medical / Health Care Information Related to HIV / AIDS and Sexually Transmitted Diseases - Maine
What Is Form WCB-220-C?
This is a legal form that was released by the Maine Workers' Compensation Board - a government authority operating within Maine. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form WCB-220-C?
A: Form WCB-220-C is a document used in Maine to release limited medical/health care information related to HIV/AIDS and sexually transmitted diseases.
Q: Why would someone need to use Form WCB-220-C?
A: Someone may need to use Form WCB-220-C to authorize the release of their medical/health care information related to HIV/AIDS and sexually transmitted diseases in specific situations.
Q: What information is released with Form WCB-220-C?
A: Form WCB-220-C releases limited medical/health care information related to HIV/AIDS and sexually transmitted diseases, as specified on the form.
Q: Who can access the released information?
A: Only authorized individuals or entities as specified on Form WCB-220-C can access the released information.
Q: Is there a fee for obtaining Form WCB-220-C?
A: There may be a fee associated with obtaining Form WCB-220-C. You should check with the healthcare provider or facility for more information.
Q: How long is Form WCB-220-C valid for?
A: The validity period of Form WCB-220-C may vary depending on the specific circumstances. It is best to consult with the healthcare provider or facility for the expiration details.
Q: Can I revoke the release of information granted by Form WCB-220-C?
A: Yes, you can revoke the release of information granted by Form WCB-220-C at any time. You should follow the specified procedure on the form to do so.
Q: Is Form WCB-220-C specific to Maine?
A: Yes, Form WCB-220-C is specific to Maine. Other states may have their own forms or procedures for authorizing the release of medical/health care information related to HIV/AIDS and sexually transmitted diseases.
Form Details:
- Released on September 1, 2018;
- The latest edition provided by the Maine Workers' Compensation Board;
- 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 fillable version of Form WCB-220-C by clicking the link below or browse more documents and templates provided by the Maine Workers' Compensation Board.
