Sample Authorization to Release Psychiyatric Or Psychological Records Letter

From: [Your Name, & Address here] To: [Recipient Name & address here] [Date here] Sub – [Patient’s name whose records are being requested] Date of Birth – […] Social Security Number – [……..] To – [Doctor’s name]   I hereby permit [association’s name] or their agent to check, evaluate and make facsimiles of the psychiatric … Read more