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1150 Lincoln Avenue, Evansville, IN 47714 pH: 8124024263 Fax: 8124374263 Ross E. Mar burger, MD John P. Morgan, MD AUTHORIZATION TO RELEASE RECORDS I, authorize (patient or patient representative

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What is authorization to release records?

Authorization to release records is a legal document that allows a party to disclose or obtain a person's confidential information or records.

Who is required to file authorization to release records?

Authorization to release records is typically filed by the individual whose information or records are being disclosed.

How to fill out authorization to release records?

To fill out an authorization to release records, one must provide their personal information, specify the parties involved, and sign the document.

What is the purpose of authorization to release records?

The purpose of authorization to release records is to ensure that confidential information is only disclosed or obtained with the consent of the individual.

What information must be reported on authorization to release records?

Information that must be reported on an authorization to release records includes the type of records being released, the parties involved, and the purpose of the disclosure.

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