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Notice of Privacy Practices of the APWU Health Plan

Forms for members to download, fill out and return:

Explanation of HIPAA Forms

  1. Authorization for Release of Protected Health Information
  2. Personal Representative Authorization
  3. Request for Access
  4. Request for Accounting of Disclosures
  5. Request for Amendment
  6. Request for Confidential Communications
  7. Request for Restriction

Certificate of Group Health Plan Coverage

Click here to download Adobe Acrobat for free. In order to view the Notice of Privacy Practices and forms, you will need to have Adobe Acrobat Reader installed on your computer. To download this free program, click on the Get Acrobat Reader button.

The APWU Health Plan reserves the right to modify this legal disclaimer and privacy policy at any time. If you have questions about the privacy statement or the practices of this web site, you should contact information@apwuhp.com.

 
 

Tel: 800-222-2798
information@apwuhp.com
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  William Burrus, President       William J. Kaczor, Jr., Director
APWU Health Plan, 799 Cromwell Park Drive, Suites K-Z, Glen Burnie, MD 21061
APWU Health Plan is a department of the American Postal Workers Union, AFL-CIO

© 1985-2009 APWU Health Plan. All rights reserved.