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Phone: 5407857768 fax: 5407857691 www.prattmed.com AUTHORIZATION TO DISCLOSE HEALTH INFORMATION NAME: DOB: PHONE #: PLEASE OBTAIN INFORMATION FROM: PLEASE RELEASE INFORMATION TO: NAME OF PROVIDER/CLINIC/ORGANIZATION

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How to fill out phone 540-785-7768 fax 540-785-7691

To fill out the phone number 540-785-7768 and fax number 540-785-7691, follow these steps:

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As for who needs the phone number 540-785-7768 and fax number 540-785-7691, anyone who is involved in communication or transactions that require exchanging information via phone calls or fax transmissions may need these contact details. This could include individuals, businesses, organizations, or institutions that rely on telecommunication methods to send and receive information.

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