HIPAA Authorization for Health Care and Insurance For Research Foundation (RF)
RF employees authorizing health care and health insurance advocacy.
Download the Form
Completing the PDF Form
- Read through all pages of the document to find specific instructions, if any
- Enter requested information into the form
- Print the form
- Get required signatures
- Scan a copy of the signed form for your records
- Send the original, completed, signed form to:
Research Foundation Human Resources
120 Crofts Hall
llNorth Campus
Need Help Completing the Form?
Form Facts
Form Type: Downloadable, PDF document
Requirements: Adobe Reader
Updated: xx/xx/2015
Owner: Research Foundation SUNY portal