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TIPS ON COMPLETING THE HEALTH ALLIANCE AUTHORIZATION FORM Where it states “I hereby authorize Health Alliance to disclose my protected health information to,” please list the name of the person(s) or organization(s)
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Document Date: 2016-08-24 00:26:19
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TIPS ON COMPLETING THE HEALTH ALLIANCE AUTHORIZATION FORM Where it states “I hereby authorize Health Alliance to disclose my protected health information to,” please list the name of the person(s) or organization(s)