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AUTHORIZATION FOR RELEASE OF MEDICAL RECORDS TO SEVEN HILLS WOMEN HEALTH CENTERSName of Facility/Provider to Release Medical Records: Address of Facility/Provider to Release Medical Records: Phone
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The name of the facility provider is the official name of the organization or individual providing services.
The entity or individual responsible for providing the services is required to file the name of the facility provider.
The name of the facility provider should be filled out on the designated form or document provided by the regulatory agency.
The purpose of providing the name of the facility provider is to ensure transparency and accountability in the service provision.
The information reported on the name of the facility provider may include the legal name, address, contact information, and any relevant licenses or certifications.
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