Cov ntaub ntawv ntiag tug hauv qab no pab tib neeg nkag mus rau lawv cov ntaub ntawv tiv thaiv kev noj qab haus huv thiab siv lwm txoj cai ntiag tug. Cov no yog cov ntaub ntawv Health Information Portability and accountability Act (HIPAA) cov ntaub ntawv siv los ntawm DHCS.

Nkag mus rau Cov Ntaub Ntawv Tiv Thaiv Kev Noj Qab Haus Huv

• Authorization for Release of Protected Health Information (DHCS 6236)
• Autorización Para La Divulgación De Información Médica Protegida (DHCS 6236 – Spanish)

Lwm Daim Ntawv Pov Thawj

• Privacy Complaint Form (DHCS 6242)
• Thov kom muaj Kev Tshaj Tawm Txog Kev Tshaj Tawm Txog Kev Tiv Thaiv Cov Ntaub Ntawv Kho Mob (DHCS 6244)
• Thov kom muaj Kev Tshaj Tawm Txog Kev Tshaj Tawm los ntawm Niam Txiv, Tus Saib Xyuas lossis Tus Neeg Sawv Cev Tus Kheej (DHCS 6245)
• Request to Amend Protected Health Information (DHCS 6238) (For Name or Address amendments contact the county in which eligibility was established)
• Thov Hloov Kho Cov Ntaub Ntawv Tiv Thaiv Kev Noj Qab Haus Huv los ntawm Niam Txiv, Tus Saib Xyuas lossis Tus Neeg Sawv Cev Tus Kheej (DHCS 6239)
• Kev Thov Kev Sib Txuas Lus Tsis pub lwm tus paub (DHCS 6235)
• Thov txwv tsis pub siv thiab nthuav tawm cov ntaub ntawv tiv thaiv kev noj qab haus huv (DHCS 6240)
• Request to Restrict Use and Disclosure of Protected Health Information by Parent, Guardian or Personal Representative (DHCS 6241)

Rov qab mus rau nplooj ntawv ntiag tug ntawm cov ntaub ntawv

Txuas ntawm nplooj ntawv no yog cov ntaub ntawv hauv Adobe Acrobat Portable Document Format (PDF).