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* '/SHAREDID5×Name: Chart: Age: Date:AUTHORIZATION FOR RELEASE OF HEALTH INFORMATION FORM Revocation Date Revoked: Initials of Privacy Official:Patient's Name (First, Middle, Last)Date of Biosocial
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St. Luke's Medical is a healthcare provider that offers medical services and facilities to patients.
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Patients who receive medical treatment or services from St. Luke's Medical may be required to fill out and file the necessary forms.
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