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  • Reference Form - Atlantic Health System - Atlantichealth

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CONFIDENTIAL REFERENCE FORM FOR VOLUNTEERS Your name has been given as a reference by , who submitted an application to the Volunteer Services Department at Morristown Medical Center. Our volunteers.

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The federal Health Insurance Portability and Accountability Act (HIPAA) requires health plans to maintain the privacy of any personal information relating to its members' physical or mental health.

You can request medical records in several ways: Complete the online patient authorization form for release of information. Mail, fax, scan or email your completed authorization form to the hospital's address. You can also stop by the hospital in person with your completed authorization form.

In New Jersey, a physician is required to maintain treatment records for seven years from the date of the most recent entry; however, questions always arise about how long a physician must retain medical records for a minor.

CAN A DOCTOR CHARGE ME FOR MY MEDICAL RECORDS? The doctor may charge you to copy your records. The cost may not be greater than $1.00 per page or $100.00 for the entire record, whichever is less. If your records are no more than 10 pages, the doctor may charge $10.00.

You have the right to get a deceased person's medical records from a New Jersey hospital if you are the deceased person's legally authorized representative, such as their surviving spouse, immediate next of kin, or legal guardian.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232