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Get OSF HealthCare Adult Proxy Form 2011-2024

Orm. The patient must sign this form and provide authorization for the release of medical information via the Adult OSF myHealth Proxy Authorization for Release of Medical Information and the OSF myHealth Proxy Authorization for Release of Mental Health / Developmental Disability Information . The patient s account will be accessed through your (the proxy s) OSF myHealth account. Completing this form will establish an OSF myHealth account for you and the patient. Return all forms.

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