Office of Institutional Compliance

Amarillo Forms

Authorization for Release of Patient Information

Business Associate Agreements for Contracts

 Word Format

Business Associate Agreements for Purchase Orders

 PDF Format Word Format

HIPAA Security Amendment

(For all agreements executed before April 21, 2005)

 PDF Format Word Format

Confidential Communication Request

 English Spanish

Consent to Treatment

 English Spanish

Complaint

 English Spanish

Request for Accounting

 English Spanish

Request to Amend PHI

 English Spanish

Release for Media Purposes

 English Spanish
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