Authorization to Release Health Information
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Patients or their legal representatives, please use this form to provide authorization to release or obtain their health information.
Medical Records Information
For more information about this form, or for information about your medical records or a patient you represent, please use the following phone numbers:
For patient last names starting with A - L, please call (315) 624-4937.
For patient last names starting with M - Z, please call (315) 624-4977.
