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Este formulario se utiliza para solicitar el registro médico del paciente, autorizando a un miembro del personal a liberar información médica específica a un tercero, con el fin de participar en deportes u otros propósitos como el tratamiento médico, el pago de facturas o la compensación laboral.

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What is authorization to release medical?

Authorization to release medical is a legal document that allows healthcare providers to disclose a patient's medical information to specified individuals or entities.

Who is required to file authorization to release medical?

Typically, the patient or their legal representative is required to file the authorization to release medical information.

How to fill out authorization to release medical?

To fill out the authorization, the patient must provide their personal information, specify the information to be released, designate recipients, and sign and date the form.

What is the purpose of authorization to release medical?

The purpose of authorization to release medical is to ensure that a patient's health information is shared only with their consent, protecting their privacy rights.

What information must be reported on authorization to release medical?

The information that must be reported includes the patient's name, date of birth, details of the information to be released, purpose of the release, names of recipients, and signatures.

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