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FollowMyHealth and Release of Information Forms

    https://clinicalcenter.nih.gov/followmyhealth/forms.html
    FollowMyHealth and Release of Information Forms. The following forms and authorizations are intended to request information from your NIH Clinical Center medical …

MEDICAL RECORD Authorization for the Release of …

    https://clinicalcenter.nih.gov/sites/nihinternet/files/internet-files/participate/_pdf/NIH-527.pdf
    MEDICAL RECORD MEDICAL RECORD Authorization for the Release of Medical Information National Institutes of Health, Clinical Center Health Information Management …

FollowMyHealth Patient Portal | Clinical Center Home Page

    https://clinicalcenter.nih.gov/followmyhealth
    Welcome to the National Institutes of Health Clinical Center FollowMyHealth ® Patient Portal, a secure system that connects you to important resources. The NIH …

Patient Information | Clinical Center Home Page

    https://clinicalcenter.nih.gov/participate/patientinfo1.html
    Consent-Authorization for Electronic Communication NIH-2984 Human Research Protections Program Legal, Ethical and Safety Issues Informed Consent, your …

Instructions on how to complete the NIH …

    https://www.cc.nih.gov/sites/nihinternet/files/internet-files/participate/_pdf/NIH-527_instructions.pdf
    Instructions on how to complete the NIH Authorization for the Release of Medical Information (NIH-527) form All fields on this form are required. 1. Patient Information: • Patient Name …

Release of Medical Records - National Institutes of Health

    https://ors.od.nih.gov/sr/dohs/HealthAndWellness/OccupationalMedical/Pages/release-records.aspx
    Release of Medical Records. Before we can honor employee requests to release medical records from OMS to another location, the employee must fax or email a completed …

All Forms - National Institutes of Health

    https://oma.od.nih.gov/DMS/Pages/Forms-Management-All-Forms.aspx
    Division of Compliance Management (DCM) Division of Program Integrity (DPI) Division of Risk Management and Audit Liaison (RMAL) Forms Management – The Forms …

MEDICAL RECORD Authorization for the Release of …

    https://science.nichd.nih.gov/confluence/download/attachments/24150153/NIH%20Med%20Record%20Release.pdf?version=1&modificationDate=1225305129000&api=v2
    Authorization for the Release of Medical Information NIH-527 (9-08) P.A. 09-25-0099 File in Section 4: Correspondence INSTRUCTIONS: Complete this form in its entirety and …

MEDICAL RECORD Authorization for the Release of …

    https://clinicalcenter.nih.gov/sites/nihinternet/files/internet-files/participate/_pdf/NIH-527-SP.pdf
    Department of Health and Human Services, HHS, National Institutes of Health, NIH, NIH Clinical Center, National Institutes of Health Clinical Center, NIH CC, Medical Record …



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