Release Medical Form

 Consent to Release of Medical History
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State:
Multi-State
Control #:
US-00460
Instant Download
Available formats: Word | Rich Text

Free Preview release medical form printable

Description ca release of medical information forms printable

This form is a consent to the release of medical history. The patient authorizes the release of his/her medical history to the specified party within the consent release form. The form also provides that all prior authorizations are cancelled.

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