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ALASKA FAMILY MEDICINE AUTHORIZATION TO RELEASE PROTECTED HEALTH INFORMATIONPlease print. Patient Another Last Names Date of birthstone NumberEmail Address Street Addressing, State, Zip co-transfer
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Online formshorizon family medicine is a digital form used for recording and reporting medical information for patients at Horizon Family Medicine.
Patients and/or their guardians are required to fill out online formshorizon family medicine for each medical appointment.
Online formshorizon family medicine can be filled out electronically on the Horizon Family Medicine website or in person at the clinic.
The purpose of online formshorizon family medicine is to gather important medical information about patients to assist healthcare providers in delivering personalized care.
Information such as medical history, current medications, allergies, and contact information must be reported on online formshorizon family medicine.
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