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Milton High SchoolMedical Authorization (page 1) Student Name:, LastFirstMiddle InitialIndicate Sport: FALL: Cross Country Football Golf Girls Pom Pons Swimming Girls Soccer Boys Tennis Girls Volleyball
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To fill out medical authorization page 1, follow these steps:
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Start by writing the current date at the top of the page.
03
Write your full legal name in the designated space provided.
04
Provide your date of birth in the format required.
05
Fill in your contact information, including your address, phone number, and email address.
06
If applicable, provide your social security number or any other identification number required.
07
Read and understand the authorization statement carefully.
08
Sign and date the form at the bottom to indicate your consent.
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Make sure to review the completed page for accuracy and completeness before submitting it.

Who needs medical authorization page 1?

01
Medical authorization page 1 is typically required by patients who are seeking medical treatment or services.
02
It may also be necessary for individuals who are authorizing someone else to make medical decisions on their behalf.
03
Healthcare providers and medical facilities may also need this form for record-keeping and legal compliance purposes.
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Medical authorization page 1 is a form that gives permission for medical information to be shared.
Patients or their legal guardians are required to file medical authorization page 1.
To fill out medical authorization page 1, you need to provide your personal information, the healthcare provider's information, and specify the information to be disclosed.
The purpose of medical authorization page 1 is to authorize the disclosure of medical information to specific individuals or organizations.
The information that must be reported on medical authorization page 1 includes the patient's name, date of birth, contact information, the purpose of the disclosure, and the specific information to be disclosed.
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