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DATE: I, hereby request the release and transfer of any pertinent dental rays and records, or copies of such, from Caring Hands Dental Clinic to; Dental clinic name address phone email / Patients
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To fill out the i hereby request form, you must provide your personal information and details of the request.
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The purpose of the i hereby request form is to document and formalize a request.
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The i hereby request form typically requires information about the requester, the request being made, and any supporting details.
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