1234, Main Street Boston, MA 02123 05 April, 2005 <Recipient Address Goes Here> Hello, Re: <name of patient whose records are being sought> Date of Birth: <date of birth of patient> Social Security Number: <social security number> To: <name of doctor or hospital> I hereby authorize <name of party or parties to acquire medical records> […]
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Search Results for: letter for medical treatment
Authorization to release psychiyatric or psychological records
1234, Main Street Boston, MA 02123 05 April, 2005 <Recipient Address Goes Here> Hello, Re: <name of patient whose records are being sought> Date of Birth: <date of birth of patient> Social Security Number: <social security number> To: <name of doctor or hospital> I hereby authorize <name of party or parties to acquire medical records> […]
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