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Woodland Professional Associates

About Patient Information

From time to time, information about your treatment may--with your authorization--be shared with other clinicians or insurance providers. The forms below can be used for such authorizations.
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Authorization to Release Information

This form, when completed and signed by you, authorizes Woodland Professional Associates to release protected information from your clinical records to another doctor or insurer.
release.93748pdf1.pdf
File Size: 53 kb
File Type: pdf
Download File

Authorization to Obtain Information

This form, when completed and signed by you, authorizes another doctor or clinician to release protected information from your clinical records to Dr. Patricia Kincare.
release.93748_pdf_2_.pdf
File Size: 53 kb
File Type: pdf
Download File

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