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AUTHORIZATION FOR RELEASE OR TRANSFER OF MEDICAL RECORDPatients full name1: Date of Birth: / / Address: City/State/Zip Code: Daytime Phone #:(Date of Authorization: / /) (month / day / year) Cell
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Signature section - cypress is a section on a document where individuals must sign to certify the authenticity and accuracy of the information provided.
Any individual or entity mentioned in the document who has the authority to certify the information.
To fill out the signature section - cypress, one must physically sign their name and date the document to indicate when the certification was made.
The purpose of the signature section - cypress is to ensure that the information provided in the document is authentic and accurate by holding individuals accountable for its contents.
The signature section - cypress must include the signature of the certifying individual, the date of certification, and any other relevant information required by the document.
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