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https://www.utsouthwestern.edu/edumedia/edufiles/about_us/admin_offices/hipaa_privacy/notice-of-privacy-practices-acknowledgement-of-receipt-english.pdf
Form # NPPARF-001 / 03.05 (Rev. 12.11) White – Health Information Management Department Yellow – Patient Reviewed 09/13 Page 1 of 1 Notice of Privacy Practices Acknowledgement of Receipt Form Your signature below indicates that you have been offered a copy of UT Southwestern Medical Center…
https://www.utsouthwestern.edu/edumedia/edufiles/about_us/admin_offices/hipaa_privacy/restriction-request-use-disclosure-phi.pdf
Form # FMA/RRFDPHI-001 / 02.03 (Rev. 07.12) (Reviewed 09/13) Page 1 of 1 (See other side for instructions) Restriction Request Form For Use and Disclosure of Protected Health Information Date: You are requesting that UT Southwestern Medical Center restrict its use and disclosure of certai…
Autorización para divulgar información médica protegida: UT Southwestern, Dallas, TX
https://www.utsouthwestern.edu/edumedia/edufiles/about_us/admin_offices/hipaa_privacy/authorization-to-disclose-phi-spanish.pdf
Nombre del paciente: _________________________________ Dirección: __________________________________________ __________________________________________________ Ciudad Estado Código postal N.º de expediente médico: Fecha de nacimiento: Sexo: Autorización …
https://www.utsouthwestern.edu/edumedia/edufiles/about_us/admin_offices/hipaa_privacy/alternate-communications-request.pdf
Form # AMA/ACRF-001 / 02.04 (Rev. 03.26.13) Original - Health Information Management Department Copy - Privacy Officer (Reviewed 09/13) Page 1 of 1 Alternate Communications Request Form Request for Alternate Communications Regarding Medical Information Date: Month / Date / Year …
Authorization to Disclose Personal Health Information: UT Southwestern, Dallas, TX
https://www.utsouthwestern.edu/edumedia/edufiles/about_us/admin_offices/hipaa_privacy/authorization-disclose-health-info.pdf
White – Health Information Management Department Yellow – Patient Page 1 of 2 Form # 7680-001 / 01.05 (Rev. 06/13/18) Authorization to Disclose Protected Health Information Instructions: Complete all applicable sections to have information disclosed from UT Southwestern Medical Center to ano…
https://www.utsouthwestern.edu/edumedia/edufiles/about_us/admin_offices/hipaa_privacy/notice-of-privacy-practices-acknowledgement-of-receipt-spanish.pdf
Form # SY2/NPPARF-002 / 11.03 (Rev. 10.01.14) White – Health Information Management Department Yellow – Patient (Reviewed 09/13) Page 1 of 1 NOTIFICACIÓN DE PRACTICAS DE PRIVACIDAD RECONOCIMIENTO DE RECIBO DEL AVISO Su firma abajo indica que le han ofrecido una copia del aviso medico de UT …
Looking Forward to the Year Ahead: From the President's Desk - UT Southwestern
https://www.utsouthwestern.edu/edumedia/edufiles/about_us/office_of_the_president/pm-year-ahead-7jan2011.pdf
Looking Forward to the Year Ahead Jan. 7, 2011 To the UT Southwestern Community: Having begun the new calendar year, I want to thank all of you for the work you do as faculty and staff to make UT Southwestern the place it is today. As a result of your efforts, much has been accomplis…
Ranked #1 in D/FW by U.S. News and World Report: From the President's Desk
https://www.utsouthwestern.edu/edumedia/edufiles/about_us/office_of_the_president/pm-us-news-31march2011.pdf
Ranked #1 in D/FW by U.S. News and World Report March 31, 2011 To the UT Southwestern Community: I am writing to publicly thank and congratulate the physicians, nurses, and all other care givers and staff whose excellence has earned UT Southwestern University Hospital #1 ranking as the …
President's Message: Strategic Planning and Implementation, Nov. 24, 2009
https://www.utsouthwestern.edu/edumedia/edufiles/about_us/office_of_the_president/pm-strategic-implementation-2009nov24.pdf
Strategic Planning and Implementation Nov. 24, 2009 To the UT Southwestern Community: I am writing to thank all who participated in our Strategic Planning Initiative through the summer and to let the entire UT Southwestern community know about some initial important decisions that have be…
New University Hospital Planning: From the President's Desk - UT Southwestern
https://www.utsouthwestern.edu/edumedia/edufiles/about_us/office_of_the_president/pm-new-hospital-12feb2010.pdf
New University Hospital Planning Feb. 12, 2010 To the UT Southwestern Community: I am writing to provide an update on one of the important efforts underway at UT Southwestern: our planning for a New University Hospital. As I’ve previously discussed, developing our academic health care sys…