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Asheville Medicine & Pediatrics Authorization for Release of Information Compound ReleaseName of Patient Date of Birth I, authorized to release protected health information about the above named patient
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What is I, authorized to release protected health ination about the above named patient in the following manner and to identified persons Form?

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I authorized to release refers to granting permission to disclose specific information or documents to a designated individual or entity.
The individual or organization seeking to release information or documents is required to fill out and file i authorized to release.
To fill out i authorized to release, one must provide their personal information, specify the information or documents being released, and indicate the recipient of the released information.
The purpose of i authorized to release is to ensure that sensitive information is only disclosed to authorized parties for legitimate reasons.
On i authorized to release, one must report the specific information or documents being released, as well as details of the recipient authorized to receive such information.
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