Louisville Kentucky Medical Release

State:
Multi-State
City:
Louisville
Control #:
US-00562
Format:
Word; 
Rich Text
Instant download

Description

This Medical Release authorizes the physicians, hospital and all medical attendants to furnish full and complete medical reports and information requested by the person signing to whomever such person designates in the agreement. This authorization also includes examination of all hospital records, x-ray film and furnishing of any information including opinions. This agreement is applicable to all states.
Free preview
  • Form preview
  • Form preview

Trusted and secure by over 3 million people of the world’s leading companies

Louisville Kentucky Medical Release