Staff Forms
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Permission to Obtain, Release and Exchange Information
Permission to Obtain Release and Exchange Information Interactive.pdf 105.51 KB (Last Modified on February 23, 2018) -
Professional Service Payment Request - Non-Employee
Professional Service Payment Request Non Employee Interactive.pdf 108.76 KB (Last Modified on April 9, 2018) -
Quartz Authorization for Disclosure of Protected Health Information
Quartz Authorization for Disclosure of Protected Health Information02142018.pdf 2.62 MB (Last Modified on February 14, 2018) -
UW Health Authorization for Disclosure of Protected Health Information
UW Health Authorization for Disclosure of Protected Health Information02142018.pdf 2.24 MB (Last Modified on February 14, 2018)