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McKenzie Pediatrics Records Release Request Form PLEASE RELEASE RECORDS TO: Todd A Huffman, MD Address: Phone: Catherine Greater, MD 1442 South A Street Springfield, OR 97477 5417264100 Fax: NATO

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What is mckenzie pediatrics records release?

McKenzie pediatrics records release is a form that authorizes the release of medical records from McKenzie Pediatrics to a designated individual or organization.

Who is required to file mckenzie pediatrics records release?

Patients or their legal guardians are required to file McKenzie pediatrics records release in order to grant permission for the release of medical records.

How to fill out mckenzie pediatrics records release?

To fill out McKenzie pediatrics records release, you must provide your personal information, specify the recipient of the medical records, and sign the form to authorize the release.

What is the purpose of mckenzie pediatrics records release?

The purpose of McKenzie pediatrics records release is to ensure that medical records are only shared with authorized individuals or organizations for specified reasons.

What information must be reported on mckenzie pediatrics records release?

McKenzie pediatrics records release must include the patient's name, date of birth, medical record number, the recipient's information, the purpose of the release, and any specific records to be released.

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