Sample Authorization to Release Medical records Letter


Warning: Undefined variable $toReturn in /home/foundlet/public_html/wp-content/plugins/searchterms-tagging-2/searchterms-tagging2.php on line 1004

Sub – [Patient name whose records are being requested]   Date of Birth – […] Social Security Number – [,,,,] To: [Doctor’s name]   I hereby give my approval to [receiver of medical records] or their representative to check, evaluate, and make copies of the medical, psychiatric, alcohol and/or drug cure records, related to the … Read more