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Get MA MADS-MR 2015-2024

Health Medical Records Release Form helps us get medical information from your health-care provider so that the MassHealth Disability Evaluation Service (DES) can make a disability determination. Please read the instructions carefully before you fill out this form. If you leave any sections of this form blank, this permission will not be valid, and the health-care provider will not be able to share your information with the MassHealth DES. If the health-care provider does not share medical infor.

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