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Medical records and imaging request - Mayo Clinic
https://www.mayoclinic.org/patient-visitor-guide/medical-records
WEBRelease of information. If you are unable to find the information you need, you can request records from your Patient Online Services account or you may contact Mayo Clinic Release of Information through one of the methods below. Phone: 507-284-4594. Fax: 507-284-0161. Email: [email protected]. Mail: Health Information Management …
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Medical Record Forms - Mayo Clinic Health System
https://www.mayoclinichealthsystem.org/for-patients-and-visitors/health-record-forms
WEBMedical Record Forms. If you're a Mayo Clinic Health System patient or have been one in the past, you can use these forms to grant permission for others to access your protected health information or request a change to your health record.
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Authorization to Release Protected Health Information to a …
https://mcforms.mayo.edu/mc0001-mc0099/mc0072-01.pdf
WEBInstructions: This form is to be used by a patient or legal representative to authorize the release of information to a third party (other than a family member or friend) such as an insurance company, employer, or for legal purposes, etc. Print clearly; each section needs to be completed to be valid. 2. Additional Patient Information.
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Contact us: How can we help you? - Mayo Clinic Health System
https://www.mayoclinichealthsystem.org/contact-us
WEBMedical Records. Call 507-284-4594 to speak to a Release of Information representative with questions about requesting copies of your records, allowing access to records and more. Request a copy of your records.
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Authorization to Release Protected Health Information - Mayo
https://mcforms.mayo.edu/mc0001-mc0099/mc0072-100.pdf
WEBRelease Information To: • Print the name of the person or organization that is to receive the medical records along with their complete address, city, state and zip code. Please include their phone number if known or check the box of the correct Mayo Clinic Health System facility. Purpose of Release:
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Requesting Medical Records and Imaging from Mayo Clinic's …
https://dev.kcms.mayoclinic.org/patient-visitor-guide/minnesota/resources/medical-records
WEBPatients may request that their medical record information be released to themselves or other third parties for various reasons. The Release of Health Information brochure (PDF) provides patients with information on release requirements and how to request release of their health records to common third parties for various reasons.
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/health-record/manage-health-records/requested-records - Mayo Clinic
https://onlineservices.mayoclinic.org/patientportal/health-record/manage-health-records/requested-records
WEBOne account for all Mayo Clinic services. Log in to patient portal. Username. Password. SHOW.
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Mayo Clinic Authorizations and Service Terms - Mayo Clinic
https://www.mayoclinic.org/patient-visitor-guide/authorization-service-terms
WEBThe Mayo Clinic Authorizations and Service Terms form is presented to all patients seen at Mayo Clinic. The form authorizes Mayo Clinic to: Provide services and treatment or care coordination. Release records to insurance company (ies), when applicable.
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Authorization to Disclose Protected Health Information BY …
https://www.mayoclinic.org/documents/authorization-pdf/DOC-20079554
WEBPurpose for release of information: Personal. Continuing Patient Care. Other. Information being requested, please specify (i.e., Physician/Provider/Service or Dates of Service or Records/Reports):
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Primary Care — First Resource - Mayo Clinic Health System
https://www.mayoclinichealthsystem.org/services-and-treatments/primary-care
WEBApr 4, 2024 · Complete a medical records release form to authorize the transfer of health records from another healthcare facility to us. Visit our Medical Record Forms page for this form and other forms in multiple languages.
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