First-Class Nursing Registry Journal
I, _________________________________________________________, acknowledge that I have contracted services from First-Class Nursing Registry, Inc., for the provision of hourly /live in services. I understand that to provide such services First-Class Nursing Registry, Inc., must obtain a release, exchange, and explore personal confidential information about me and my health status. I hereby authorize First-Class Nursing Registry, Inc., to communicate verbally or in writing with any individual’s institutions it deems necessary; including, but not limited to my physicians, nurses, and hospitals to better assist me in my care.
This includes permission to review and obtain copies of records containing my protected health information: This authorization
This includes permission to review and obtain copies of records containing my protected health information: This authorization