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Authorization for Disclosure of Health Care Information
This Authorization affects your rights in the privacy of your personal health care information. Please read it carefully before signing.
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Salem City Liability Waiver
AUTHORIZATION FOR MEDICAL. TREATMENT This release will authorize Mountain View Hospital and Salem City Ambulance Service to provide medical treatment in the
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Request Medical Records - Oregon Health Authority
Patients, or their authorized representatives, may request copies of medical records NE. Salem, OR 97301-2682; Fax: 503-945-9855 Attn: Health Information
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