Re Hipaa Form For Dr. Satish Cuddapah¶

Sarah,

It is a form used to authorize the release of medical records to someone other than the patient. I dont have one handy but can draft one if needed. The simpler approach would be for the Dr. to send you the medical records directly.

http://www.wczlaw.net/

Rich Capriola

Winter Capriola Zenner, LLC

One Ameris Center 3490 Piedmont Road NE, Suite 800 Atlanta, GA 30305 www.wczlaw.com http://www.wczlaw.com/

rcapriola@wczlaw.com rcapriola@wczlaw.com

View Bio https://wczlaw.com/attorneys/chadd-l-reynolds/

tel

dir tel

404.844.5700

404.844.5637

This communication (together with all attachments) may contain privileged or confidential information and its sender reserves and asserts all rights that may apply to it. If you are not the intended recipient or believe that you have received this communication in error, please do not print, copy, retransmit, disseminate or otherwise use the information. Also, please indicate to the sender that you have received this communication in error and delete the copy you received. Thank you.

Tax Advice Disclosure: To ensure compliance with requirements imposed by the IRS under Circular 230, we inform you that any U.S. federal tax advice contained in this communication (including any attachments), unless otherwise specifically stated, was not intended or written to be used, and cannot be used, for the purpose of (1) avoiding penalties under the Internal Revenue Code or (2) promoting, marketing or recommending to another party any matters addressed herein.

From: Sally L. Monico SCook@mmatllaw.com Sent: Friday, March 11, 2022 11:57 AM To: Sarah Zeeman szeeman@gmail.com; Lucy Aquino lucy.aquino@swiftcurrie.com; Richard J. Capriola rcapriola@wczlaw.com Cc: Tania Tuttle ttuttle@mmatllaw.com Subject: FW: hipaa form for Dr. Satish Cuddapah

CAUTION: This email originated from outside the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe.

Sarah, I am not familiar with the HIPPA form he references. Copying Rich as he is the person to assist with below question/request.

Thanks.

Sally Monico 11625 Rainwater Drive | Ste. 125 | Alpharetta, Georgia 30009 Direct: 404.365.4506

Main: 404.266.9171

smonico@mmatllaw.com smonico@mmatllaw.com *PLEASE NOTE MY NEW EMAIL ADDRESS

CONFIDENTIALITY NOTICE No attorney-client relationship exists by virtue of this communication in absence of an engagement letter or fee contract. In addition, unless you are in the To: or CC: line of this email, you are not an intended recipient. The information accompanying this email transmission may contain confidential or legally privileged information meant for ONLY the intended recipient. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or reliance upon the contents of this email is strictly prohibited. If you receive this email in error, please delete this email and notify the sender immediately.

From: Sarah <szeeman@gmail.com szeeman@gmail.com > Sent: Thursday, March 10, 2022 7:49 PM To: Lucy.Aquino@swiftcurrie.com Lucy.Aquino@swiftcurrie.com ; Sally L. Monico <SCook@mmatllaw.com SCook@mmatllaw.com > Subject: hipaa form for Dr. Satish Cuddapah

Hi,

Can you all help me with faxing him the lawyer hipaa form he mentions in his voicemail?

Thank you in advance.

Smokeball Reference: 5ab3d264-03bd-4ce8-b9f1-2c8a9bf470a8/e904d6c3-c446-4c81-a160-48f8c7e4cc78.