TRS-64 Sample of Authorization for Access to Patient Information
-
Sample of Authorization for Access to Patient Information (TRS-64) - English
Sample consent form to authorize the disclosure of Information through a Health Information Exchange Organization.
Download
-
Sample of Authorization for Access to Patient Information (TRS-64) - Arabic
العَرَبِي (Arabic)Sample consent form to authorize the disclosure of Information through a Health Information Exchange Organization.
Download
-
Sample of Authorization for Access to Patient Information (TRS-64) - Polish
Polski (Polish)Sample consent form to authorize the disclosure of Information through a Health Information Exchange Organization.
Download