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RECORDS RELEASE Feel Better Please fill out this form completely. 2315 W. 57th Street Sioux Falls, SD 57108 (605) 3363503 8883363503 Fax (605) 3366010 www.midwestent.com Date needed by: Today's Date:
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How to fill out ment-115 records release:

01
Begin by filling in the date at the top of the form.
02
Provide your full name, address, phone number, and email address in the designated spaces.
03
Indicate the purpose of the records release, such as for medical or educational purposes.
04
Specify the type of records you are authorizing to be released, whether it is medical records, academic transcripts, or other relevant documents.
05
If you have any specific restrictions or limitations on the release of records, mention them clearly. For example, you may want to exclude certain sensitive information.
06
Sign and date the form, acknowledging your consent for the release of records.
07
If required, provide any additional information or documentation requested by the organization receiving the form.
08
Keep a copy of the completed ment-115 records release for your records.

Who needs ment-115 records release:

01
Individuals seeking medical treatment from a healthcare provider may be required to provide a ment-115 records release to authorize the release of their medical records to other healthcare professionals.
02
Students who are transferring schools or applying for educational programs may need to fill out a ment-115 records release to allow their academic transcripts to be sent to the relevant institutions.
03
Job applicants who need to provide proof of past employment or professional qualifications may be asked to complete a ment-115 records release to authorize the release of their employment records or certifications.
Please note that the specific requirements for the ment-115 records release may vary depending on the organization or institution requesting the form. It is essential to carefully review the instructions provided and ensure that you accurately complete the form to meet the specific requirements of the recipient.
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Ment-115 records release is a form used to release records or information to authorized parties.
Individuals or organizations who need to release records or information to authorized parties are required to file ment-115 records release.
To fill out ment-115 records release, you need to provide the required information about the records or information being released, as well as information about the authorized parties.
The purpose of ment-115 records release is to authorize the release of records or information to specific parties.
On ment-115 records release, you must report details about the records or information being released, as well as information about the authorized parties.
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