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Authorization for the Disclosure of Protected Health Information - for the Purpose of Removal of Firearm Disability - Nebraska
Authorization for the Disclosure of Protected Health Information - for the Purpose of Removal of Firearm Disability is a legal document that was released by the Nebraska Department of Health and Human Services - a government authority operating within Nebraska.
FAQ
Q: What is the Authorization for the Disclosure of Protected Health Information?
A: It is a document that allows the release of a person's health information.
Q: What is the purpose of the Authorization for the Disclosure of Protected Health Information - for the Purpose of Removal of Firearm Disability?
A: To remove a person's firearm disability in the state of Nebraska.
Q: Who needs to sign the Authorization for the Disclosure of Protected Health Information - for the Purpose of Removal of Firearm Disability?
A: The person seeking to have their firearm disability removed.
Q: What information is disclosed in this document?
A: Protected health information relating to the person's mental health.
Q: Is this authorization specific to Nebraska?
A: Yes, it applies to the state of Nebraska.
Q: What is the purpose of removing a firearm disability?
A: To allow a person who was previously restricted from owning or possessing firearms to regain their rights.
Form Details:
- Released on March 1, 2017;
- The latest edition currently provided by the Nebraska 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 Nebraska Department of Health and Human Services.
