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J. Isaac Bachelor, M.D. Val K. Shaw, M.D. Kristine M. Sandbagger, M.D. Pediatrics Michael Merry, O.D. Eye Physicians & Surgeons Comprehensive Ophthalmology RECORDS RELEASE FORM I hereby request that

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What is records release form?

A records release form is a document that authorizes the release of a person's confidential information to a specified party.

Who is required to file records release form?

Anyone who wishes to have their confidential information released to a third party must file a records release form.

How to fill out records release form?

To fill out a records release form, you must provide your personal information, specify the information you wish to release, and indicate the party to whom the information should be released.

What is the purpose of records release form?

The purpose of a records release form is to ensure that confidential information is only released to authorized parties and to protect the privacy of individuals.

What information must be reported on records release form?

The information that must be reported on a records release form includes the individual's name, contact information, the information to be released, and the party authorized to receive the information.

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