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Orthopedic associates patient release form

Orthopedic associates patient release form 2025

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The document is an authorization form for the release of medical records from Orthopedic Associates of Dutchess County, PC, specifically for processing disability claims. It includes patient information, consent for disclosure of medical records, and details regarding payment for the service. The document also contains a claimant information form related to disability claims and a credit card payment authorization section.

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