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UNIVERSITY OF MICHIGAN HOSPITALS & HEALTH CENTERSREQUEST FOR OUTSIDE RECORDS PATIENT INFORMATION FROM ANOTHER ORGANIZATION (Authorization to Request)For Clinic Use Only: Date Request Sent: Mailed

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Any individual or organization that requires information from the other organization for various purposes may need this information. This can include government agencies, regulatory bodies, financial institutions, auditors, legal entities, researchers, partners, stakeholders, or any other party involved in the relevant processes or transactions.

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What is information from another organization?

Information from another organization is data or details provided by a separate entity.

Who is required to file information from another organization?

Any individual or entity that has received information from another organization may be required to file it.

How to fill out information from another organization?

Information from another organization can typically be filled out online or through traditional paper forms.

What is the purpose of information from another organization?

The purpose of information from another organization is to share relevant data or details with other parties.

What information must be reported on information from another organization?

The specific information that must be reported on information from another organization will vary depending on the situation.

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