Document

FORM IHS-810

ICR 202309-0917-001 · OMB 0917-0030 · Object 135624901.

Document Viewer [docx]

Status: Original and derived artifacts are available for this document.

Download: docx | pdf | html

Primary: docxSource: application/octet-stream
Loading document viewer…

Document Metadata

Record metadata
application/octet-stream
FORM IHS-810
Authorization for Use or Disclosure of Protected Health Information
PSC Publishing Services
Writer
2023-09-20
2026-08-18
complete