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AUTHORIZATION TO RELEASE HEALTHCARE INFORMATIONPatients name___ DOB___I request and authorize Dr. Mahsa Sohrab to release my healthcare information to: Name___Mail to address___ or Fax to ___ Attention___This
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How to fill out sohrab medical records release

01
Obtain a copy of the medical records release form from Sohrab Medical Center.
02
Fill in your personal information including your name, date of birth, address, and contact information.
03
Specify the medical records you are requesting to be released, including the dates of treatment and the healthcare providers involved.
04
Sign and date the form to authorize the release of your medical records.
05
Submit the completed form to the medical records department at Sohrab Medical Center either in person, by mail, or by fax.

Who needs sohrab medical records release?

01
Patients who want to transfer their medical records to a different healthcare provider.
02
Insurance companies requesting medical records for billing purposes.
03
Attorneys for legal proceedings that require access to medical records.
04
Researchers conducting studies that require access to medical records.
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Sohrab medical records release is a legal document that allows individuals to authorize the sharing of their medical records with specified parties, ensuring that medical information is disclosed appropriately.
Patients or their legal representatives are required to file a sohrab medical records release when they wish to grant access to their medical records to healthcare providers, insurance companies, or other entities.
To fill out a sohrab medical records release, one must provide personal identification information, specify the records to be released, list the recipient of the records, and sign the document to authorize the release.
The purpose of a sohrab medical records release is to facilitate the transfer of medical information between healthcare providers and patients or other designated entities while ensuring compliance with privacy laws.
The information required on a sohrab medical records release typically includes the patient's name, date of birth, contact information, the specific medical records being requested, the recipient’s information, and the patient's signature.
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