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Medical Records Request & Authorization  Phoenix Children's Hospital  Form

Medical Records Request & Authorization Phoenix Children's Hospital Form

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Also includes examination of all hospital records, x-ray film and furnishing of any information including opinions, which will aid the said attorney in the prosecution of claims against insurance carriers, and others for injury sustained. Your full cooperation with my attorneys is requested. You are further requested not to disclose such information to any other person without written authority to do so. HIPAA Release Authority. My agent shall be treated as I would be with respect to my rights...
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