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HIPAA Form (English – Dentistry)

April 6, 2016 by Happy Tooth

AES 256 Encryption

Authorization for Release of Medical Information

This form must be completed by the individual whose protected health information is to be disclosed or by a parent or guardian if the person is a minor under state law.

Important note:  This page is secured and encrypted using AES_256_CBC, with HMAC-SHA1 (same as the U.S. government) for message authentication and RSA as the key exchange mechanism.


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