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Complete all sections, then sign and date at the end of the form. I,. , authorize the Rhode Island Office of State Medical Examiners to.PHONE: 401-456-8055 FAX: 401-456-8890. Providence, RI 02906. Phone: 401-793-7967 Fax: 401-793-2247. Opioid Products – Rhode Island. Authorization to Release Information Forms. Form Title, Form Number, Edit link. Medical Records Disclosure Authorization - Ortho Rhode Island. What should be included in a authorization for release of information?