This is a legal form that was released by the Wyoming Department of Health - a government authority operating within Wyoming. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form F-12?
A: Form F-12 is a document used to impose restrictions on the use and disclosure of protected health information.
Q: Who uses Form F-12?
A: Form F-12 is typically used by healthcare providers or organizations in Wyoming.
Q: What is the purpose of Form F-12?
A: The purpose of Form F-12 is to protect the privacy and confidentiality of a patient's health information.
Q: What does Form F-12 restrict?
A: Form F-12 restricts the use and disclosure of protected health information by healthcare providers or organizations.
Form Details:
Download a printable version of Form F-12 by clicking the link below or browse more documents and templates provided by the Wyoming Department of Health.