Liability Waiver

AUTHORIZATION FOR USE OR DISCLOSURE OF HEALTH INFORMATION

Completion of this document authorizes the disclosure and use of health information about you Under California law, all recipients of protected health care information may not redisclose it except as required or permitted by law. Information disclosed pursuant to this authorization may be subject to redisclosure by the recipient and no longer protected by HIPAA regulations. Please check your local state HIPAA laws and regulations. All information given and shared is confidential and protected by the laws of California.