Form RSA-1312A-LP Authorization for Disclosure of Health Information to Rsa - Large Print - Arizona

Form RSA-1312A-LP Authorization for Disclosure of Health Information to Rsa - Large Print - Arizona

What Is Form RSA-1312A-LP?

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

FAQ

Q: What is the RSA-1312A-LP form?
A: The RSA-1312A-LP form is an Authorization for Disclosure of Health Information in large print.

Q: What is the purpose of the RSA-1312A-LP form?
A: The purpose of the form is to authorize the disclosure of health information.

Q: Who is the intended recipient of the RSA-1312A-LP form?
A: The form is intended for Rsa in Arizona.

Q: What does "LP" stand for in RSA-1312A-LP?
A: LP stands for large print.

Q: What type of information can be disclosed with this form?
A: The form allows for the disclosure of health information.

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Form Details:

  • Released on September 1, 2022;
  • The latest edition provided by the Arizona Department of Economic Security;
  • 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 fillable version of Form RSA-1312A-LP by clicking the link below or browse more documents and templates provided by the Arizona Department of Economic Security.

Download Form RSA-1312A-LP Authorization for Disclosure of Health Information to Rsa - Large Print - Arizona

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