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*OB299* AUTHORIZATION TO DISCLOSE HEALTH INFORMATION CDH 299 Rev. 10/1/2013Medical Record # PATIENT FULL NAME: (please print) DATE OF BIRTH: PHONE: CELL PHONE: INFORMATION REQUESTED: Dates of treatment:
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What is cooley dickinson hospital?
Cooley Dickinson Hospital is a non-profit community hospital located in Northampton, Massachusetts.
Who is required to file cooley dickinson hospital?
Cooley Dickinson Hospital is required to file their financial reports with the appropriate regulatory agencies.
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Cooley Dickinson Hospital can fill out their financial reports online or in the prescribed paper format provided by the regulatory agencies.
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The purpose of Cooley Dickinson Hospital is to provide medical care and services to the community.
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Cooley Dickinson Hospital must report their financial information, patient statistics, and other relevant data.
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