South Carolina Blues - Protected Health Information Forms

 

Protected Health Information Forms

For Individuals/Families and Employees of Businesses with 2-50 Employees

Forms for Individuals/Families and Employees 

Authorization to Disclose Protected Health Information to a Third Party
Autorización Para Revelar Información Protegida De Salud a Terceros

For Employees of Businesses with 50 or More Employees

Authorization to Disclose Protected Health Information