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AUTHORIZATION TO OBTAIN AND/OR RELEASE HEALTHCARE INFORMATION Patient Name: Date of Birth: I hereby authorize Northern Maine Medical Center to Obtain and/or Release my health information as described
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Start by gathering all relevant personal information, such as your name, date of birth, and contact information.
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Provide details about your medical history, including any previous surgeries or medical conditions.
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Include emergency contact information.
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Who needs health informationmedical records?
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Health information medical records are needed by:
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- Patients: to keep track of their medical history and provide accurate information to healthcare providers.
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- Healthcare providers: to have a comprehensive understanding of a patient's health history, allergies, and medications.
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- Emergency responders: to quickly access critical medical information during emergencies.
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- Insurance companies: to assess a patient's health status and determine coverage eligibility.
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- Researchers: to analyze anonymous medical records for studies and medical advancements.
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