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Allina Hospitals & Clinics / Buffalo Hospital / Medical record / United Hospital / Health informatics / Medical informatics / Medicine / Health
Date: 2013-10-30 11:18:10
Allina Hospitals & Clinics
Buffalo Hospital
Medical record
United Hospital
Health informatics
Medical informatics
Medicine
Health

ALLINA HEALTH AUTHORIZATION TO RELEASE AND DISCLOSE PATIENT INFORMATION PATIENT INFORMATION NAME: ______________________________________________________ DATE OF BIRTH: ______________________ Address: ____________________

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Source URL: www.allinahealth.org

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