Form preview

Get the free (Please choose one or both below)

Get Form
For office use only Medical Record # ___Medical Record Release AuthorizationDATE ___ ROI# ___Patient NameMaiden/Previous NameDate of BirthHome PhoneCell/WorkAddressCity/State/ZIPI.D. ___ I hereby
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign please choose one or

Edit
Edit your please choose one or form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your please choose one or form via URL. You can also download, print, or export forms to your preferred cloud storage service.

How to edit please choose one or online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
In order to make advantage of the professional PDF editor, follow these steps below:
1
Log in. Click Start Free Trial and create a profile if necessary.
2
Prepare a file. Use the Add New button to start a new project. Then, using your device, upload your file to the system by importing it from internal mail, the cloud, or adding its URL.
3
Edit please choose one or. Replace text, adding objects, rearranging pages, and more. Then select the Documents tab to combine, divide, lock or unlock the file.
4
Get your file. Select your file from the documents list and pick your export method. You may save it as a PDF, email it, or upload it to the cloud.
With pdfFiller, it's always easy to work with documents. Try it!

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out please choose one or

Illustration

How to fill out please choose one or

01
Begin by reviewing the options available in the 'please choose one or' section.
02
Determine the correct choice based on your specific needs or preferences.
03
Click on the appropriate selection from the dropdown menu or list.
04
Ensure your selection is visible and highlighted in the form.
05
Continue filling out any other required fields for the form.

Who needs please choose one or?

01
Individuals filling out a form that requires a choice to be made from multiple options.
02
People seeking to clarify their preferences in a survey or application.
03
Participants in an event or program needing to select an option related to their attendance or involvement.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.3
Satisfied
33 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

In your inbox, you may use pdfFiller's add-on for Gmail to generate, modify, fill out, and eSign your please choose one or and any other papers you receive, all without leaving the program. Install pdfFiller for Gmail from the Google Workspace Marketplace by visiting this link. Take away the need for time-consuming procedures and handle your papers and eSignatures with ease.
The pdfFiller mobile app makes it simple to design and fill out legal paperwork. Complete and sign please choose one or and other papers using the app. Visit pdfFiller's website to learn more about the PDF editor's features.
Create, modify, and share please choose one or using the pdfFiller iOS app. Easy to install from the Apple Store. You may sign up for a free trial and then purchase a membership.
Please choose one or refers to a selection prompt often used in forms or assessments where the individual must select one option from a given set of choices.
The individuals or entities required to file depend on the specific context of the form or document in question, typically stated in the instructions accompanying it.
To fill out please choose one or, review the options provided, select the most appropriate choice that applies to your situation, and follow any specific instructions given.
The purpose of please choose one or is to prompt the user to make a decision from a set of alternatives, ensuring that the necessary information is captured accurately.
The information that must be reported varies depending on the specific form or context; however, it usually includes details relevant to the selected choice.
Fill out your please choose one or online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.