DOH Form 669-386 Consent for Release of Information - Washington

DOH Form 669-386 Consent for Release of Information - Washington

What Is DOH Form 669-386?

This is a legal form that was released by the Washington State Department of Health - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DOH Form 669-386?
A: DOH Form 669-386 is the Consent for Release of Information form.

Q: What is the purpose of DOH Form 669-386?
A: The purpose of DOH Form 669-386 is to authorize the release of your medical information.

Q: Who needs to fill out DOH Form 669-386?
A: Anyone who wants to authorize the release of their medical information needs to fill out DOH Form 669-386.

Q: Is DOH Form 669-386 only applicable in Washington?
A: Yes, DOH Form 669-386 is specific to Washington State.

Q: Are there any fees associated with submitting DOH Form 669-386?
A: There may be fees associated with the release of medical records, but this would depend on the healthcare provider's policies.

Q: How long does it take for the information to be released after submitting DOH Form 669-386?
A: The timeline for releasing medical information may vary depending on the healthcare provider. It is best to check with them directly.

Q: Can I revoke my consent after submitting DOH Form 669-386?
A: Yes, you can revoke your consent for the release of information at any time by notifying your healthcare provider in writing.

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Form Details:

  • Released on November 1, 2020;
  • The latest edition provided by the Washington State 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 DOH Form 669-386 by clicking the link below or browse more documents and templates provided by the Washington State Department of Health.

Download DOH Form 669-386 Consent for Release of Information - Washington

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