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Records Release Form

Condition New

Form authorizing release of medical records.

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Send to a friend

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Records Release Form
<p>Form authorizing release of medical records.</p>

Recipient :

Name of your friend ^* :

E-mail address of your friend ^* :

^* Required fields

or Cancel
Print

Data sheet

Pages	1
Customizable	Yes

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This simple medical records release form helps our office to appear competent and professional in our communications with other offices.

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Cool Springs EyeCare

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Address:
Cool Springs EyeCare
3252 Aspen Grove #1
Franklin, Tennessee 37067
United States