{"id":4030,"date":"2019-10-03T02:03:25","date_gmt":"2019-10-03T02:03:25","guid":{"rendered":"\/?page_id=4030"},"modified":"2019-10-11T01:34:27","modified_gmt":"2019-10-11T01:34:27","slug":"release-and-use-of-health-information","status":"publish","type":"page","link":"https:\/\/www.washingtonnephrology.com\/index.php\/for-patients\/new-patient\/release-and-use-of-health-information\/","title":{"rendered":"Release and Use of Health Information"},"content":{"rendered":"

[et_pb_section fb_built=”1″ _builder_version=”3.29.3″ fb_built=”1″ _i=”0″ _address=”0″][et_pb_row _builder_version=”3.29.3″ _i=”1″ _address=”0.1″][et_pb_column type=”4_4″ _builder_version=”3.29.3″ _i=”0″ _address=”0.1.0″][et_pb_text _builder_version=”3.29.3″ text_font_size=”20px” header_text_align=”center” custom_padding=”||0px|||” _i=”0″ _address=”0.1.0.0″]<\/p>\n

Release and Use of Health Information<\/strong><\/h1>\n

 <\/p>\n

\u00a0PATIENT AUTHORIZATION WAIVER FOR DISCLOSURE OF INFORMATION TO ANY WASHINGTON NEPHROLOGY ASSOCIATES ADMINISTRATIVE STAFF EMPLOYEE TO DISCUSS ANY MEDICAL CONDITION (S) WITH FAMILY MEMBERS OR DESIGNATED PERSON (S)<\/span><\/p>\n

\u00a0I am a patient of Washington Nephrology Associates, L.L.P. (WNA) and hereby authorize the support staff. I.e. secretaries, medical assistants, nurses, etc. to discuss my medical condition with the members of my family listed in the Registration Form.<\/span>\u00a0<\/span><\/p>\n

The patient or the patient’s \u00a0legal representative must read the following statements:<\/p>\n

A. \u00a0I understand that the provision of health care and the payment of health care will not be affected if this form is not signed.<\/p>\n

B. \u00a0I understand that I may revoke this authorization at any time by notifying Washington\u00a0Nephrology Associates in writing, but it will not affect any actions taken by Washington\u00a0Nephrology Associates prior to receiving the revocation.<\/p>\n

Please initial and sign on Registration Form<\/p>\n

 <\/p>\n

[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_6,1_6,1_6,1_6,1_6,1_6″ _builder_version=”3.29.3″ max_width=”1599px” custom_margin=”|589px||149px||” custom_padding=”|0px||4px||” _i=”0″ _address=”0″ global_module=”4404″][et_pb_column type=”1_6″ _builder_version=”3.29.3″ _i=”0″ _address=”0.0″][et_pb_button button_url=”\/index.php\/for-patients\/new-patient\/” button_text=”Back” _builder_version=”3.29.3″ custom_button=”on” button_text_color=”#ffffff” button_bg_color=”#0c71c3″ button_use_icon=”off” custom_padding=”|||15px||” _i=”0″ _address=”0.0.0″ button_bg_enable_color=”on”][\/et_pb_button][\/et_pb_column][et_pb_column type=”1_6″ _builder_version=”3.29.3″ _i=”1″ _address=”0.1″][\/et_pb_column][et_pb_column type=”1_6″ _builder_version=”3.29.3″ _i=”2″ _address=”0.2″][\/et_pb_column][et_pb_column type=”1_6″ _builder_version=”3.29.3″ _i=”3″ _address=”0.3″][\/et_pb_column][et_pb_column type=”1_6″ _builder_version=”3.29.3″ _i=”4″ _address=”0.4″][\/et_pb_column][et_pb_column type=”1_6″ _builder_version=”3.29.3″ _i=”5″ _address=”0.5″][et_pb_code _builder_version=”3.29.3″ custom_margin=”|||80px||” custom_padding=”11px|950px||108px|false|false” custom_css_before=”.pom-default {|| background-image: url(‘print-icon.png’);|| background-repeat: no-repeat;|| width: 32px;|| height: 32px;||}” _i=”0″ _address=”0.5.0″]

<\/div>[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"

Release and Use of Health Information   \u00a0PATIENT AUTHORIZATION WAIVER FOR DISCLOSURE OF INFORMATION TO ANY WASHINGTON NEPHROLOGY ASSOCIATES ADMINISTRATIVE STAFF EMPLOYEE TO DISCUSS ANY MEDICAL CONDITION (S) WITH FAMILY MEMBERS OR DESIGNATED PERSON (S) \u00a0I am a patient of Washington Nephrology Associates, L.L.P. (WNA) and hereby authorize the support staff. I.e. secretaries, medical assistants, […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":666,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-4030","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.washingtonnephrology.com\/index.php\/wp-json\/wp\/v2\/pages\/4030","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.washingtonnephrology.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.washingtonnephrology.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.washingtonnephrology.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.washingtonnephrology.com\/index.php\/wp-json\/wp\/v2\/comments?post=4030"}],"version-history":[{"count":0,"href":"https:\/\/www.washingtonnephrology.com\/index.php\/wp-json\/wp\/v2\/pages\/4030\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/www.washingtonnephrology.com\/index.php\/wp-json\/wp\/v2\/pages\/666"}],"wp:attachment":[{"href":"https:\/\/www.washingtonnephrology.com\/index.php\/wp-json\/wp\/v2\/media?parent=4030"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}