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AUTHORIZATION FOR THE RELEASE OF MEDICAL INFORMATION: I authorize Orthopedic Performance Institute, LLC to release any medical information requested by insurance companies with whom I have coverage
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Start by clearly printing or typing your full name in the space provided for the authorized signature.
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Various individuals or entities may require an authorized signature "I authorize," depending on the context.
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For example, it may be needed when giving permission for someone else to act on your behalf, such as in legal documents or business transactions.
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The authorized signature is a legally recognized individual who has the authority to sign important documents or agreements on behalf of a person or organization.
The authorized signature is typically required to be filed by the person or entity responsible for the agreement or document being signed.
To fill out an authorized signature, simply write the name of the authorized individual and have them sign their name on the designated line.
The purpose of the authorized signature is to signify that the document or agreement has been reviewed and agreed upon by the authorized individual.
The authorized signature must include the name of the authorized individual and their signature, as well as the date of signing.
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