![28280217-fillable-mobile-medical-authorization-form-wakehealth](https://cdn.cocodoc.com/cocodoc-form/png/28280217-fillable-mobile-medical-authorization-form-wakehealth-x-01.png)
baptist authorization
Wake forest baptist health wake forest baptist medical center patient name: medical record #: department name: wfbh health information management. authorization for use or disclosure of protected health information telephone number: (336) 716-3230...
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