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RECORDS TRANSFER REQUEST DATE: TO: ADDRESS: CITY: STATE: ZIP I hereby authorize the release of any current rays and pertinent records for Patient Name(s) Patients signature Please Mail to: Howard
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How to fill out records transfer request

How to fill out records transfer request:
01
Start by obtaining the necessary form or template for the records transfer request. This may be available from your organization's records management department or office.
02
Begin by providing your identifying information in the designated fields on the form. This typically includes your name, contact information, department, and position.
03
Indicate the purpose of the records transfer request. Clearly state the reason for the transfer and any relevant background information. Be concise and specific.
04
Specify the records you wish to transfer. Include details such as the record type, title, and any applicable identification numbers. If possible, provide a brief description of each record to aid in its identification.
05
Provide the desired transfer destination for the records. This could be another department, office, or an external organization. Include their contact information to ensure accurate delivery.
06
Indicate the desired date or timeline for the records transfer. This will help facilitate the processing and coordination of the transfer.
07
If there are any special instructions or requirements for the transfer, such as the need for secure handling or confidentiality, clearly specify these in the request.
08
Ensure that you have reviewed the completed form for accuracy and completeness. Double-check all the provided information before submitting the request.
09
Once the records transfer request is filled out, submit it according to your organization's procedures. This may involve submitting it through an online portal, delivering it in person, or sending it via email or interoffice mail.
Who needs records transfer request:
01
Employees who are changing departments or leaving the organization and need their records transferred to the new department or to their successor. This ensures a smooth transition and availability of essential information for the new personnel.
02
Departments within an organization that require access to specific records from another department. This could be for collaboration purposes, research, or to fulfill their own operational needs.
03
Organizations or individuals outside of the company who require access to certain records for legal, regulatory, or contractual reasons. This could include government agencies, auditors, or business partners who need access to specific information.
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