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Get Invisalign Patient Transfer Authorization Form

Authorizing the release of their personal medical records, Doctor, orally or in writing, regarding such Medical Records and from doctor __________________________________________ the transfer thereof, or other medical information that may be (i) to doctor ____________________________________________, considered confidential under a state health or safety code, or an Invisalign® Trained doctor (hereinafter “New Doctor”) for (ii) considered “individually identifiable health informati.

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