Public Safety Personnel Retirement System Forms and Office Locations – Government Agency in Arizona

61 - 80 of 132 forms

Form Title	Topics
FORM U3 Beneficiary Lump Sum Distribution Election Form
FORM U3 Beneficiary Lump Sum Distribution Election Form
HIPAA – Authorization for Use and Disclosure of PHI (not required for packet or claims)
HIPAA – Authorization for Use and Disclosure of PHI (not required for packet or claims)
HIPAA – Privacy Complaint Form (not required for packet or claims)
HIPAA – Privacy Complaint Form (not required for packet or claims)
HIPAA – Privacy Complaint Form (not required for packet or claims)
HIPAA – PSPRS Notice of Privacy Practice
HIPAA – PSPRS Notice of Privacy Practices
HIPAA – PSPRS Notice of Privacy Practices
HIPAA – Request for Access to Electronic Health Record (EHR) (not required for packet or claims)
HIPAA – Request for Access to Electronic Health Record (EHR) (not required for packet or claims)
HIPAA – Request for Access to Electronic Health Record (EHR) (not required for packet or claims)
HIPAA – Request for Access to PHI (not required for packet or claims)
HIPAA – Request for Access to PHI (not required for packet or claims)
HIPAA – Request for Access to PHI (not required for packet or claims)
HIPAA – Request for Accounting of Disclosures of PHI (not required for packet or claims)
HIPAA – Request for Accounting of Disclosures of PHI (not required for packet or claims)
HIPAA – Request for Accounting of Disclosures of PHI (not required for packet or claims)
HIPAA – Request for Amendment of PHI (not required for packet or claims)

Public Safety Personnel Retirement System