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AUTHORIZATION FORM MIM #710S For Radiology Films please send: 500 Keystone Drive Chapel Hill, NC 27514 For all other record requests please send: ATTN: IMAGING SUPPORT ATTN: RELEASE OF MEDICAL INFORMATION

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What is form - 710s authorization?

Form 710s authorization is a document that allows an individual to authorize someone else to act on their behalf for specific financial or legal matters.

Who is required to file form - 710s authorization?

Individuals who want to grant authority to another person to make decisions or take actions on their behalf in certain situations are required to file form 710s authorization.

How to fill out form - 710s authorization?

Form 710s authorization can be filled out by providing the necessary information about the individual granting authority, the person being granted authority, and the specific powers being authorized.

What is the purpose of form - 710s authorization?

The purpose of form 710s authorization is to legally document the authorization given by an individual to another person to act on their behalf in specific situations.

What information must be reported on form - 710s authorization?

Information such as the names and contact details of both parties, the specific powers being authorized, and the duration of the authorization must be reported on form 710s authorization.

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