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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 …
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/privacy-complaint-form.pdf
Form # OCA/PCF-001 / 07.12 (Reviewed 09/13) Page 1 of 1 PRIVACY COMPLAINT FORM For Patient Use Only For Internal Use Only Tracking Number If you have questions about completing this form, please call 214-648-6080 and leave a message. Date Your First Name Your Last Name Home Phone ( …
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…
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 …
https://www.utsouthwestern.edu/about-us/administrative-offices/purchasing/supplier-faqs.pdf
Supplier FAQs - Revised September 2023 Page 1 of 1 Supply Chain Management (SCM) Guideline Frequently Asked Questions (FAQs) Effective Date: September 2023 1. How can I do business with UT Southwestern Medical Center? Visit UT Southwestern Medical Center’s Supplier Bid …
https://www.utsouthwestern.edu/edumedia/edufiles/about_us/admin_offices/hipaa_privacy/request-accounting-disclosures.pdf
Form # FMA/RADI-001 / 03.03 (Rev. 08/15) (Reviewed 09/13) Page 1 of 1 You have the right to request that UT Southwestern Medical Center provide an accounting of certain disclosures of your protected health information. An accounting of disclosures may include disclosures up to 6 years prior t…
UTSW Insider - September 29, 2025
https://www.utsouthwestern.edu/archive/campus-updates/insider092925.pdf
10/6/25, 10:42 AM
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Outlook
The UTSW Insider | Monday, Sept. 29, 2025
From UTSW Insider
UTSW Insider - September 10, 2025
https://www.utsouthwestern.edu/archive/campus-updates/insider091025.pdf
9/14/25, 6:08 PM
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Outlook
The UTSW Insider | Wednesday, Sept. 10, 2025
From UTSW Insider
UTSW Insider - October 2, 2023
https://www.utsouthwestern.edu/archive/campus-updates/insider100223.pdf
Monday, October 2, 2023 ICYMI: Listen to the President’s Campus Briefing Last week UT Southwestern President Daniel K. Podolsky, M.D., delivered his first campus briefing of the 2024 academic year and highlighted recent accomplishments across all mission areas. The full address from Sept. 27 is avai…