Omsi 581 form 2025

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The document is an authorization form for the release of a patient's health information, detailing the process for requesting medical records either in paper or electronic format. It includes sections for patient identification, types of information requested, and acknowledgment of understanding regarding the disclosure of sensitive health information. The form also outlines the rights of the patient to revoke authorization and provides instructions for electronic delivery through HealthPort.

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2012	4.8 Satisfied (198 Votes)

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