MEDICAL RECORDS RELEASE CONSENT FORM. This form authorizes patients’ medical records to be released from Memorial Rheumatology. Download & FAX RECORDS TO OUR SECURE FAX: 713-360-2021
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Download and print the form using the button to the right and fill it out with pen and paper and return it to our office.
Esta dirección de correo electrónico está siendo protegida contra los robots de spam. Necesita tener JavaScript habilitado para poder verlo. Teléfono: 713-360-2020 Fax: 713-360-2021