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Authorization Form for the Disclosure of Protected 42 Cfr Part 2 Patient Records by Nh Dhhs to an Entity Without a Tpr - New Hampshire
Authorization Form for the Disclosure of Protected 42 Cfr Part 2 Patient Records by Nh Dhhs to an Entity Without a Tpr is a legal document that was released by the New Hampshire Department of Health and Human Services - a government authority operating within New Hampshire.
FAQ
Q: What is the purpose of the Authorization Form?
A: The Authorization Form is used to disclose protected patient records by NH DHHS to an entity without a TPR.
Q: What is 42 CFR Part 2?
A: 42 CFR Part 2 is a federal regulation that protects the confidentiality of substance abuse patient records.
Q: What is NH DHHS?
A: NH DHHS refers to the New Hampshire Department of Health and Human Services.
Q: What is TPR?
A: TPR stands for Treatment, Payment, and Operations. It is a defined relationship with the patient and permits access to their protected records.
Q: Who needs to complete the Authorization Form?
A: The entity that wants to receive protected patient records from NH DHHS without a TPR needs to complete the Authorization Form.
Form Details:
- Released on September 9, 2019;
- The latest edition currently provided by the New Hampshire Department of Health and Human Services;
- Ready to use and print;
- Easy to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of the form by clicking the link below or browse more documents and templates provided by the New Hampshire Department of Health and Human Services.
Download Authorization Form for the Disclosure of Protected 42 Cfr Part 2 Patient Records by Nh Dhhs to an Entity Without a Tpr - New Hampshire
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