DSHS Form 02-566 Protected Health Information (Phi) Amendment - Washington

DSHS Form 02-566 Protected Health Information (Phi) Amendment - Washington

What Is DSHS Form 02-566?

This is a legal form that was released by the Washington State Department of Social and Health Services - 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 DSHS Form 02-566?
A: DSHS Form 02-566 is a form used in Washington for the amendment of Protected Health Information (PHI).

Q: What is Protected Health Information (PHI)?
A: Protected Health Information (PHI) refers to any information that relates to the past, present, or future health status of an individual and is used to identify the individual.

Q: Why would I need to use DSHS Form 02-566?
A: You may need to use DSHS Form 02-566 to request an amendment to your Protected Health Information (PHI) in Washington.

Q: Are there any fees associated with submitting DSHS Form 02-566?
A: There are no fees associated with submitting DSHS Form 02-566 in Washington.

Q: What should I do if I have questions or need assistance with DSHS Form 02-566?
A: If you have questions or need assistance with DSHS Form 02-566, you can contact the Washington State Department of Social and Health Services (DSHS) or your healthcare provider for guidance.

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Form Details:

  • Released on July 1, 2021;
  • The latest edition provided by the Washington State Department of Social and Health Services;
  • 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 DSHS Form 02-566 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.

Download DSHS Form 02-566 Protected Health Information (Phi) Amendment - Washington

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