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Authorization for Release of Protected Health Information gA disclosure statement, as required by law, will accompany all records released. gRelease of my records will be for the purpose stated on this form.

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HIPAA Privacy & Security Awareness Training for Students February 2010 1.Privacy and Security Awareness Introduction Numerous federal and state laws require that UPMC protect information that is created or collected for a variety of

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1 Smoke-Free environment To protect our patients, visitors, and staff from the harmful effects of second-hand smoke, smoking is not permitted anywhere on UPMC property.

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STEP BY STEP . INSTRUCTIONS . FOR COMPLETING THE ELEVATOR INSPECTION REPORT. These instructions provide user information by category for completing the written and bubbled portions of DBPR Form HR 5023003, Elevator - Inspection Report. Begin in the upper left corner of the inspection report.

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