Directory Results for Torresdale Pediatrics Record Release to Torresdale Pediatrics Transfer Record Request Child Identifier 1 2 3 4 Child s Full Name Child s Date of Birth Primary Address: Patient Phone: ( ) I hereby authorize the release of all ination in my child(ren) s medical record from n

Torresdale Pediatrics Transfer Record Request Child Identifier 1 2 3 4 Child s Full Name Child s Date of Birth Primary Address: Patient Phone: ( ) I hereby authorize the release of all ination in my child(ren) s medical record from n