3. Re-disclosure. Patient acknowledges that the Recipient may re-disclose Patient’s PHI/PII such that it may no longer be protected under HIPPA or other laws applicable to Prosocial and/or the Recipient.
4. Digital Documentation. A copy, fax or email of this authorization will be as valid as the original.
I certify that this request is made voluntarily and that the information given above is accurate to the best of my knowledge.