Authorization to release healthcare information (online)

 Authorization to release healthcare information (online) 

Description

Complete this online form template authorizing your healthcare provider to release your private medical records to the parties you specify. Just click and type each placeholder to fill in your own information. Template can be easily adjusted to fit a variety of standard (letter, legal, executive, card, etc.) paper sizes.

Version:
Word 2013
Downloads:
7,283
File Size:
42 KB
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