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Privacy Forms

Privacy Forms and Descriptions Give MoreCare permission to discuss or disclose personal and health information or to share information/documents for a specific purpose

Stop MoreCare from discussing or disclosing your personal health information with a previously authorized individual or group

Give permission to have your substance use treatment providers share information with other members of your health care team

Request an accounting of when MoreCare discloses your personal health information for reasons other than for Treatment, Payment, or Healthcare Operations, or for disclosures made with your authorization or permission

Request an amendment to your health information maintained by MoreCare or entities on behalf of MoreCare

Request that MoreCare restrict disclosures of your health information or request MoreCare provide your protected health information (PHI) by alternative means or at alternative locations

Provides MoreCare permission to use your name and/or story in its Media, Educational or Promotional materials