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Charlotte North Carolina Consentimiento médico para la divulgación de información - Medical Consent for Release of Information

Category:
Liberaciones - Renuncias - Consentimientos y permisos
State:
Multi-State
City:
Charlotte
Control #:
US-00460-1
Format:
Word
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Description

This form is a consent to the release of medical history. The patient authorizes the release of his/her medical history to the specified party within the consent release form. Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.
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Charlotte North Carolina Consentimiento médico para la divulgación de información
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