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Get and Sign Patient Services & Forms Northeast Georgia Health System

Get and Sign Patient Services & Forms Northeast Georgia Health System

Use a Patient Services & Forms Northeast Georgia Health System 0 template to make your document workflow more streamlined.

_______________________________________________ __ Fax:_____________________________ to disclose protected health information from the medical record of the above-listed patient, as noted here: (_____) Entire Medical Record - this includes specific permission to release all records and other information regarding: psychological notes, drug or alcohol abuse notes, AIDS and other STD related information, all laboratory and x-ray reports, consultation reports, surgical reports and other...
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