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AUTHORIZATION FOR RELEASE OF MEDICAL RECORDS Patient Name: ___ Patient DOB:___ Patient Address:___ Patient Email:___ Patient Phone Number:___ INFORMATION TO BE RELEASED TO: 3rd Party Name:___ 3rd
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What is Saunders Formrapy Centers Maple?
Saunders Formrapy Centers Maple is a healthcare facility that focuses on providing specialized therapies and treatments for patients with various needs.
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Individuals receiving treatment or services at Saunders Formrapy Centers Maple may be required to file forms as part of their treatment plan or insurance requirements.
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