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RECORDS REQUEST BY JIM PHILLIPS, Jr. D.M.D. 761 North Dean Road Auburn, AL 36830 (334) 8215291 (334) 8215292 Fax info@drphillipsdental.com HIPPO AUTHORIZATION FOR RELEASE OF PROTECTED HEALTH INFORMATION
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Contact the agency or organization where the records are being requested from.
02
Submit a written request for the records, including specific details such as the type of record being requested and any relevant dates or names.
03
Include sufficient contact information for the agency to reach out if there are any questions or issues with the request.
04
Follow up with the agency if there are delays or no response to the request.

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Anyone who requires access to specific records held by an agency or organization, such as researchers, journalists, or individuals seeking their own records.
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The records request by Jim is a formal request for information or documentation made by Jim.
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The purpose of the records request by Jim is to obtain specific information or documentation for a particular purpose.
The records request by Jim must include details such as the type of records being requested, the reason for the request, and any required supporting documentation.
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