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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-R
for the current year.
Form WCB-220-R Revocation of Limited Release of Medical / Health Care Information - Maine
What Is Form WCB-220-R?
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-R?
A: Form WCB-220-R is a document used in Maine to revoke a limited release of medical/health care information.
Q: What does Form WCB-220-R do?
A: Form WCB-220-R allows an individual to revoke a previously granted limited release of medical/health care information.
Q: Why would I need to use Form WCB-220-R?
A: You may need to use Form WCB-220-R if you previously authorized the release of your medical/health care information but now wish to revoke that authorization.
Q: How do I fill out Form WCB-220-R?
A: To fill out Form WCB-220-R, you will need to provide your personal information and indicate the limited release of medical/health care information you wish to revoke.
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-R by clicking the link below or browse more documents and templates provided by the Maine Workers' Compensation Board.
