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Download - HIPPA-1... · HIPPA-1. HIPPA-2. AUTHORIZATION TO DISCLOSE PROTECTED HEALTH INFORMATION Developed for Texas Health & Safety Code § 181.154(d) Please read this entire form before signing

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Page 1: HIPPA-1... · HIPPA-1. HIPPA-2. AUTHORIZATION TO DISCLOSE PROTECTED HEALTH INFORMATION Developed for Texas Health & Safety Code § 181.154(d) Please read this entire form before signing

HIPPA-1

Page 2: HIPPA-1... · HIPPA-1. HIPPA-2. AUTHORIZATION TO DISCLOSE PROTECTED HEALTH INFORMATION Developed for Texas Health & Safety Code § 181.154(d) Please read this entire form before signing

HIPPA-2

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