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

1. Read through all pages of the document to find specific instructions, if any
   
2. Enter requested information into the form
3. Print the form
4. Get required signatures
5. Scan a copy of the signed form for your records
6. Send the original, completed, signed form to:         

Human Resources
University at Buffalo
Townsend Hall
205 Hayes Road
Buffalo, NY 14214