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Fax 763-785-8424 Fax 763-785-3329 Fax 763-785-7716 AUTHORIZATION FOR RELEASE OF PROTECTED HEALTH INFORMATION (PHI) Patient Name Date of Birth Last First MI Home Phone: Work: Cell: RELEASE TO: Mail
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What is fax 763-785-8424?
fax 763-785-8424 is a specific fax number used for submitting documents.
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