authorization to release medical records to third party - Page 2

8932205-fillable-authorization-for-disclosure-of-health-information-from-thedacare-thedacare

thedacare medical records

Authorization for the disclosure of health information photocopy or facsimile of the original authorization will be considered as valid as the original patient patient name/ previous names associated with patient date of birth or medical record...

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thedacare medical records