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TOTAL CARE PEDIATRICSLithia Spring, GA. 30122Fax: 470.582.9386Thornton, Suite Phone: 470.502.0202AUTHORIZATION TO RELEASE PROTECTED HEALTH INFORMATION (PHI)Release and/or Disclose records and information
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How to fill out tcp medical records release

01
Obtain the appropriate medical records release form from the TCP office or website.
02
Fill out the patient's name, date of birth, and contact information at the top of the form.
03
Specify the medical records you are requesting by providing the name of the healthcare provider, dates of service, and specific records needed.
04
Sign and date the form to authorize the release of the medical records.
05
Submit the completed form to the TCP office or healthcare provider for processing.

Who needs tcp medical records release?

01
Individuals who need access to their own medical records for personal use or to provide to another healthcare provider.
02
Legal representatives or guardians who are authorized to request medical records on behalf of a patient.
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TCP medical records release is a form used to authorize the release of an individual's medical records.
The individual or their authorized representative is required to file a TCP medical records release.
To fill out a TCP medical records release, the individual must provide their personal information, the healthcare provider's information, and sign the form to authorize the release of their medical records.
The purpose of TCP medical records release is to allow healthcare providers to release an individual's medical records to authorized parties, such as other healthcare providers or insurers.
The TCP medical records release form typically requires the individual's name, date of birth, contact information, healthcare provider's information, a description of the records to be released, and the reason for the release.
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