Columbus Ohio Consentimiento médico para la divulgación de información - Medical Consent for Release of Information

State:
Multi-State
City:
Columbus
Control #:
US-00460-1
Format:
Word
Instant download

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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Columbus Ohio Consentimiento médico para la divulgación de información