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SeniorCare Notice of Privacy Practices
Privacy Notice and Forms
- SeniorCare Notice of
Privacy Practices (English,
Hmong,
Laotian [PDF, 312KB],
Russian, Spanish)
- Wisconsin SeniorCare HIPAA Privacy Authorization for Use or Disclosure
F-3161 (PDF 109 KB)
- Wisconsin SeniorCare HIPAA Privacy Access Request F-13162 (PDF 100 KB)
- Wisconsin SeniorCare HIPAA Privacy Accounting Request F-13163
(PDF 92 KB)
- Wisconsin SeniorCare HIPAA Privacy Alternate Communication Request F-13164
(PDF 96 KB)
- Wisconsin SeniorCare HIPAA Privacy Amendment Request F-13165
(PDF 88 KB)
- Wisconsin SeniorCare HIPAA Privacy Complaint F-13166
(PDF 92 KB)
- Wisconsin SeniorCare HIPAA Privacy Revocation of Authorization F-13167
(PDF 96 KB)
- Wisconsin SeniorCare HIPAA Privacy Restriction Request F-13168
(PDF 88 KB)
- SeniorCare Authorization of Representative F-10080
(PDF 72 KB)
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Spanish -
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Si necesita ayuda para traducir o entender este texto, por
favor llame al telιfono 1-800-657-2038 (V/TTY)
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Russian -
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Если вам не
всё
понятно в
этом
документе,
позвоните
по
телефону
1-800-657-2038 (V/TTY)
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Hmong -
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Yog xav tau kev pab txhais cov ntaub ntawv no
kom koj totaub, hu rau
1-800-657-2038 (V/TTY)
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Laotian -
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1-800-657-2038 (V/TTY)
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Date Last Revised:
April 03, 2009
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