HIPAA / Privacy Form

The pdf forms have been tagged and made accessible for screen assistive technologies. If you need assistance filling out or translating this PDF form please contact our office at 727-824-8181. If you do not have a printer, a copy will be provided for you at any CHCP location.

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Privacy Notice Form(English)
 267 Downloads
 114.36 KB
 12-15-2020

Privacy Notice Form(Spanish)
 196 Downloads
 70.66 KB
 12-15-2020

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