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INSTITUTE OF DIAGNOSTIC IMAGING Medical Release Authorization of Protected Health InformationRelease my medical record(s) to my health care provider: All recordsSpecific records check below: XrayMammogramCTUltrasoundMRISend
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Submit the filled-out form to the Institute of Diagnostic Imaging.

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The Institute of diagnostic imaging is a facility that uses diagnostic imaging techniques to aid in the diagnosis of medical conditions.
Medical professionals or facilities that perform diagnostic imaging services are required to file Institute of diagnostic imaging.
The Institute of diagnostic imaging form must be filled out accurately and completely with all relevant information about the imaging services provided.
The purpose of the Institute of diagnostic imaging is to track and monitor diagnostic imaging services provided by medical professionals or facilities.
Information such as the type of imaging services provided, number of procedures performed, and patient demographics must be reported on Institute of diagnostic imaging.
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