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This document is a formal request for the release of dental records and radiographs from a previous dentist to Dr. Doki Hwang and Dr. Jun Sung Park at the Aurora Dental Centre. It includes details regarding patient rights, information required for the transfer, and contact information for the dental clinic.
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What is request for patient records?
A request for patient records is a formal application made to obtain an individual's medical records from a healthcare provider or facility.
Who is required to file request for patient records?
Individuals, such as patients, authorized representatives, or legal guardians, are typically required to file a request for patient records.
How to fill out request for patient records?
To fill out a request for patient records, you need to provide your personal information, details about the records you are requesting, the purpose of the request, and your signature for consent.
What is the purpose of request for patient records?
The purpose of a request for patient records is to gain access to an individual's medical history for personal use, to share with another healthcare provider, or for legal reasons.
What information must be reported on request for patient records?
The request must include the patient's full name, date of birth, contact information, specific records requested, and the signature of the person making the request.
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