![466000877-hipaa-release-of-information-to-family](https://cdn.cocodoc.com/cocodoc-form/png/466000877--hipaa-release-of-information-to-family--x-01.png)
hipaa release of information to family
Alpha rehabilitation, p.c. authorization to release medical information to family member(s), guardian, and others first & last name of patient: date of birth: i hereby authorize medical providers and personnel of alpha rehabilitation, p.c. to...
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