LEGAL FORMS

 

PA Dept. of Labor & Industry:

Workers' Compensation Subpoena (.pdf)

 

HIPAA - Health Insurance Portability

and Accountability Act Forms:

 

Florida-

 

Motion for Qualified Protective Order (.wpd)

Protective Order Form (.wpd)

 

New Jersey-

 

Authorization Form (.frm)

 

Pennsylvania-

 

Facility Page
Abington Memorial Hospital 1    
Albert Einstein Healthcare Network 1    
Atlantic City Medical Center 1    
Brandywine Hospital 1    
Chart One 1    
Chesnut Hill 1    
Christiana Care 1    
Community Radiology 1 2  
Cooper Health System 1    
Crozer Keystone Health System 1 2  
-Crozer Chester Medical Center      
-Delaware County Memorial Hospital      
-Taylor Hospital      
-Springfield Hospital      
Drexel University College of Medicine 1    
Elkins Park Hospital 1 2  
Episcopal Campus (TU Hospital) 1    
Frankford Hospitals 1 2  
Hahnemann University Hospital 1 2 3
University of Pennsylvania Health System 1    
Jeanes Hospital (TU Health System) 1    
Thomas Jefferson University Hospital 1    
Jefferson University Physicians 1    
Main Line Health 1 2  
   -Bryn Mawr Hospital      
   -Bryn Mawr Rehab      
   -Lankenau Hospital      
   -Paoli Memorial Hospital      
Medical College of Pennsylvania Hospital 1    
MCS Group, Inc. 1 2  
Mercy Health System 1    
     -Mercy Fitzgerald Hospital      
     -Mercy Hospital of Philadelphia      
     -Mercy Suburban Hospital      
     -Nazareth Hospital      
     -St. Agnes Medical Center      
MVP Health 1    
Northeastern Hospital (TU Health System) 1    
Rothman Institute 1    
Parkview Hospital 1    
Roxborough Memorial Hospital 1 2  
St. Christopher's Hospital for Children 1 2  
St. Mary Medical Center 1 2 3
Susquehanna Health System 1    
-Divine Providence Hospital      
-Muncy Valley Hospital      
-Skilled Unit      
-Williamsport Hospital      
Virtua Health 1 2  
   

 

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