Fillable ELECTRONIC NOTICE OF PRIVACY PRACTICES (Cameron University)

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ELECTRONIC NOTICE OF PRIVACY PRACTICES (Cameron University)

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_____________________________________
Cameron University
Health Plan
ELECTRONIC NOTICE OF PRIVACY PRACTICES
I request to receive the University’s Health Plan NPP via email at the
following address:
OR
I withdraw my request to receive the University’s Health Plan’s NPP via
email.
I may request a paper copy of the NPP at any time.
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Rev 1/2015 © 2015 Retain for minimum of 6 years
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ELECTRONIC NOTICE OF PRIVACY PRACTICES (Cameron University)

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Completed 22 July 2020

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