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Medical Records Release

Medical Records Release

The Medical Record Release form is for the authorization for release of medical information. This form must be completed and signed by the patient/guardian in order for the provider to release the patient's medical records. 100 forms per tablet.

Order 5 or more and receive 10% off. Order 10 or more and receive 15% off.
Your Price:$19.95
Part Number:T120MR
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Quantity Pricing
Quantity
Price
  • 5 - 10
  • $17.96
  • 10+
  • $16.96
This form is for the authorization for release of medical information. This form must be completed and signed by the patient/guardian in order for the provider to release the patient's medical records.

Tablets of 100 single-sided forms, pre-punched and cut to fit into the patient file.

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