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AMIGA PALATE, Board Certified PsychiatristAuthorization to Release and Disclose Patient Information Patient Name: Information: Address: City:DOB:Sent:Name: Address:Send From: Name:Address:Phone: State:Zip:DOB:
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Amita Talati, MD, is a psychiatrist who provides mental health services, diagnoses, and treats mental disorders.
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The purpose of Amita Talati, MD, as a psychiatrist is to diagnose, treat, and manage mental health disorders to improve the overall well-being of her patients.
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Information such as patient demographics, mental health history, current medications, and presenting issues must be reported in the documentation.
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