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demographic information such as name, address, contact
numbers, etc.
Patient Authorization Form
This form must be completed in order for us speak to your
insurance company and your healthcare providers or
facilities on your behalf.
Medical Records Release Form
This form authorizes us to pull medical records for the sole
purpose of resolving financial issues between you and your
health insurance company.
numbers, etc.
Patient Authorization Form
This form must be completed in order for us speak to your
insurance company and your healthcare providers or
facilities on your behalf.
Medical Records Release Form
This form authorizes us to pull medical records for the sole
purpose of resolving financial issues between you and your
health insurance company.
