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Below is a list of medical record release forms. Should you have any questions about which one is appropriate, please feel free to contact our medical records department at (910) 323-3183 ext: 103. |
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Related Documents:
- PATIENT AUTHRO FOR USE AND DISCLOSURE OF PROTECTED HEALTH INFORMAITON.doc
This form will enable us to share you records with another facility. - PATIENT DISCLOSURE TO FAMILY MEMBER AUTH.doc
This form grants, a person of your choice access to your records. - PATIENT RELEASE FROM OTHER OFFICE.doc
This form will enable us to request your records from another facility.