Effective Time Period. The term “Effective Time Period” has the meaning set forth in Section 3.2(b).
Effective Time Period. This authorization is valid until the earlier of the occurrence of the death of the individual; the individual reaching the age of majority; or permission is withdrawn; or the following specific date (optional): Month Day Year RIGHT TO REVOKE: I understand that I can withdraw my permission at any time by giving written notice stating my intent to revoke this authorization to the person or organization named under “WHO CAN RECEIVE AND USE THE HEALTH INFORMATION.” I understand that prior actions taken in reliance on this authorization by entities that had permission to access my health information will not be affected. SIGNATURE AUTHORIZATION: I have read this form and agree to the uses and disclosures of the information as described. I understand that refusing to sign this form does not stop disclosure of health information that has occurred prior to revocation or that is otherwise permitted by law without my specific authorization or permission, including disclosures to covered entities as provided by Texas Health & Safety Code § 181.154(c) and/or 45 C.F.R. § 164.502(a)(1). I understand that information disclosed pursuant to this authorization may be subject to re-disclosure by the recipient and may no longer be protected by federal or state privacy laws. SIGNATURE X _ _ Signature of Individual or Individual’s Legally Authorized Representative DATE Printed Name of Legally Authorized Representative (if applicable): If representative, specify relationship to the individual: ¨ Parent of minor ¨ Guardian ¨ Other A minor individual’s signature is required for the release of certain types of information, including for example, the release of information related to certain types of reproductive care, sexually transmitted diseases, and drug, alcohol or substance abuse, and mental health treatment (See, e.g., Tex. Fam. Code § 32.003). 13 SIGNATURE X _ _ Signature of Minor Individual DATE Important Information About the Authorization to Disclose Protected Health Information Developed for Texas Health & Safety Code § 181.154(d) effective June 2013 The Attorney General of Texas has adopted a standard Authorization to Disclose Protected Health Information in accordance with Texas Health & Safety Code § 181.154(d). This form is intended for use in complying with the requirements of the Health Insurance Portability and Accountability Act and Privacy Standards (HIPAA) and the Texas Medical Privacy Act (Texas Health & Safety Code, Chapter 181). Covered Entities may use thi...
Effective Time Period. The Sick Leave Bank shall be effective September 15th through the last work day of the school year for all employees who have met the probationary period.
Effective Time Period. The effective time of the intended Merger will be the date (hereinafter referred to as the "Effective Time") as set forth in Section 6(d) hereof, subject to fulfillment of all prior conditions as set forth in this Agreement.
Effective Time Period. The effective time period of this agreement is from the formulation of this contract to March 31, 2011.
Effective Time Period. This Right of Entry and Release Agreement shall commence August 1, 2022 and terminate once the project has been completed but no later than the anticipated date of December 31, 2024.
