Document
IHS Form 913, Request for an Accounting of Disclosures
ICR 201908-0917-001 · OMB 0917-0030 · Object 94210901.
This document may belong to an older filing. More recent activity for OMB 0917-0030:
Document Viewer [docx]
Status: The document is viewable, but some background extraction is still pending.
Queue: Repair is queued and waiting for the next worker pass. (priority 70 · next 2026-06-09 18:53:02)
Missing: html
Download: Source copy (docx)
Loading document viewer…
Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | IHS Form 913, Request for an Accounting of Disclosures |
| Subject | OMB Approved HIPAA Public Use Forms |
| Author | IHS |
| File Created | 2021-01-15 |
| Conversion State | partial |