Medical Authorization

 Authority for Release of Medical Information
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State:
Multi-State
Control #:
US-00426
Instant Download
Available formats: Word | Rich Text

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Description release medical print

Patient authorizes the physicians, medical attendants, and the hospital to furnish full and complete medical information to the specified attorney at law, or to any representative or investigator from his/her firm. The form also provides that all prior authorization is cancelled.

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