Patient Forms and Consents
Mid-State Health Center’s Notice of Privacy Practices (HIPAA Notice)
Mid-State Health Center’s Patient Bill of Rights
Summary of Billing and Payment Policies
Record Release To/From Mid-State
Designation of a Personal Representative
Revocation of a Personal Representative
Part 2 Authorization to Release PHI (Substance Use Related Services)
Patient Consent to Permit Health Information Sharing between Mid-State and:
New Hampshire Accountable Care Partners ACO:
New Hampshire Accountable Care Partners Notice & Information for Patients