32 Miss. Code. R. § 22-3.10.1.4 - HRC Medical Information Requests

To obtain medical records from one of the Hospital Rehabilitation Centers (HRC), send to the liaison counselor Consent to Disclose Information (MDRS-VR-19) form, which will contain the following:

* Client's medical record number

* Full name

* Address

* Date of birth

* Social Security number

* Date(s) of the medical report(s) being requested

UNDER NO CIRCUMSTANCES SHOULD CLIENT CONSENT TO DISCLOSE FORM BE SENT DIRECTLY TO THE HRC. SEND ONLY TO THE LIAISON COUNSELOR.

Notes

32 Miss. Code. R. § 22-3.10.1.4