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Section A: Authorization for Release of Protected Health Information (PHI) Patient Name: Birth Date:Medical Record #: DOS: Medical Records Dept Phone: 5617988680 Fax: 5617988578 Recipient Name (Person
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Wellington Regional Medical Center is a hospital located in Wellington, Florida.
Wellington Regional Medical Center is typically required to be filed by the hospital administration or management.
Wellington Regional Medical Center can be filled out by providing the required information such as patient data, medical services provided, and financial information.
The purpose of Wellington Regional Medical Center is to report on the medical services provided by the hospital and to ensure compliance with healthcare regulations.
Information such as patient demographics, diagnoses, treatments, procedures, and billing information must be reported on Wellington Regional Medical Center.
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