HIPAA Authorization for Health Care and Insurance For Research Foundation (RF)

RF employees authorizing health care and health insurance advocacy.

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  1. Read through all pages of the document to find specific instructions, if any
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  4. Get required signatures
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  6. Send the original, completed, signed form to:         

Human Resources
ÃÛÌÒ´«Ã½
Townsend Hall
205 Hayes Road
Buffalo, NY 14214

Attn. Research Foundation Human Resources

Need Help Completing the Form?

Zachary Jenney.

Zachary Jenney

Manager

Research Foundation Benefit Services

Phone: 716-645-4439

Email: zjenney@buffalo.edu

Form Facts

Form Type: Downloadable, PDF document

Requirements:

Updated: unknown

Owner: Research Foundation SUNY portal