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Get Allina Form 2018-2024

Ient must sign this form and provide authorization for release of health information. Please note that the patient s chart will be accessed through your (the proxy s) Allina Health account. Completing this form will establish an Allina Health account for you and access to the adult s interactive health record. Return all forms to: Account Services or fax 612-262-1424 Mail Route 10607, 2925 Chicago Avenue, Minneapolis, MN 55407 Your information: (all sections required please print c.

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