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Get Walmart Pharmacy Records Request

Wal-Mart, SAM S Club, and Neighborhood Market Pharmacies, collectively Wal-Mart . This request must be made in writing, and may be denied by Wal-Mart under certain circumstances. Your request will be acted upon within 30 days (60 days if the information is off site), unless we provide you with notification in writing that an extension of up to 30 days is needed. Section 1: Patient Information Patient Name: Date of Birth: Address: City: State: Zip: Phone: Section 2: Information Req.

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