Womack Army Medical Center Medical Records/x Raw Image:/72cfa13a765c075dd9a67f9f105765e2ba383625d4f106ef29fe0faf2c158636

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AUTHORIZATION FOR RELEASE OF MEDICAL INFORMATION (Hospital) Lester E Cox Medical Center South Springfield Vacation Rentals House. Medical Records Release Letter Template Samples Letter Template.

Womack Army Medical Center Medical Records/x Raw Image:/72cfa13a765c075dd9a67f9f105765e2ba383625d4f106ef29fe0faf2c158636

Hospital Directory. MEDICAL RECORDS RELEASE Pa�ent Name: DOB: I authorize the following custodian/en�ty to release the requested Medical Recor.

AUTHORIZATION FOR RELEASE OF MEDICAL INFORMATION (Hospital)

AUTHORIZATION: I give permission to use and release to Recipient Name:

Womack Army Medical Center Medical Records/x Raw Image:/72cfa13a765c075dd9a67f9f105765e2ba383625d4f106ef29fe0faf2c158636

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