Form 20-715-05WA Refusal Form or Modification of Refusal Form - Quebec Health Record (Qhr) - Quebec, Canada

Form 20-715-05WA Refusal Form or Modification of Refusal Form is used in Quebec, Canada for the Quebec Health Record (QHR). It is used to refuse or modify consent to the collection, use, and disclosure of personal health information in the QHR.

The Form 20-715-05WA Refusal Form or Modification of Refusal Form for the Quebec Health Record (QHR) in Quebec, Canada is filed by the individual who wishes to refuse or modify their health record.

FAQ

Q: What is Form 20-715-05WA?
A: Form 20-715-05WA is the Refusal Form or Modification of Refusal Form for the Quebec Health Record (Qhr) in Quebec, Canada.

Q: What is the Quebec Health Record (Qhr)?
A: The Quebec Health Record (Qhr) is a system used to electronically store and access health information for residents of Quebec, Canada.

Q: What is the purpose of Form 20-715-05WA?
A: Form 20-715-05WA is used to refuse or modify consent for the sharing of health information through the Quebec Health Record (Qhr).

Q: Who is required to fill out Form 20-715-05WA?
A: Any resident of Quebec, Canada who wishes to refuse or modify consent for the sharing of their health information through the Quebec Health Record (Qhr) is required to fill out this form.

Q: Is Form 20-715-05WA applicable only in Quebec, Canada?
A: Yes, Form 20-715-05WA is specifically designed for residents of Quebec, Canada and is not valid or applicable in other regions or countries.

Q: Is there a deadline for submitting Form 20-715-05WA?
A: There is no specific deadline for submitting Form 20-715-05WA, but it is recommended to complete and submit the form as soon as possible if you wish to refuse or modify consent for the sharing of your health information through the Quebec Health Record (Qhr).

Q: What happens after I submit Form 20-715-05WA?
A: Once you submit Form 20-715-05WA, your refusal or modification of consent will be recorded in the Quebec Health Record (Qhr) system and healthcare providers will be notified of your preferences regarding the sharing of your health information.

Q: Can I change my mind after submitting Form 20-715-05WA?
A: Yes, you can change your mind after submitting Form 20-715-05WA. If you wish to revoke or modify your refusal or consent preferences, you can do so by completing and submitting a new form.

Q: Is there a fee for submitting Form 20-715-05WA?
A: No, there is no fee for submitting Form 20-715-05WA. It is provided free of charge to residents of Quebec, Canada.