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Medical Records | Duke Health

    https://www.dukehealth.org/medical-records
    Written authorization is required for medical records and must be submitted directly to the hospital’s Health Information Management department. You may mail the request to the centralized release of information department: Duke University Hospital Health …

Order Your Patients' Medical Records - Duke Health

    https://physicians.dukehealth.org/order-your-patients-medical-records
    Download the Duke Health Enterprise Request for External Records Form in English (PDF, 952 KB) Download the Duke Health Enterprise Request for External Records Form in …

AUTHORIZATION FOR RELEASE OF …

    https://www.dukehealth.org/sites/default/files/2019-04-01_duke_health_authorization_for_release_of_information.pdf
    Medical Record #: PART B: PERSON OR COMPANY WHO WILL RECEIVE INFORMATION . Self (same info as above) Person or Entity: Phone: Email: Address: …

REQUEST FOR EXTERNAL RECORDS - Duke Health

    https://www.dukehealth.org/sites/default/files/general_page/M20UP%20045%20Request%20for%20External%20Records_1.pdf
    Request for External Records PART A: PATIENT INFORMATION Patient Name: Phone: Email: Address: Date of Birth: SS# (last 4 digits): Duke Health Medical Record #: Duke …

AUTHORIZATION FOR RELEASE OF …

    https://physicians.dukehealth.org/sites/default/files/media_browser/M3-13-21AuthorizationtoReleaseProtectedHealthInformation.pdf
    SEND COMPLETED FORM TO: [email protected]; Fax: 919-620-5165 OR Duke University Hospital - HIM, DUMC Box 3016, Durham, NC 27710; For Questions …

For Patients | Duke Department of Radiology

    https://radiology.duke.edu/patient-care/patients
    Duke will provide your radiologic study or other medical records on CD upon written request. Click here for further details. GENERAL INFORMATION Duke University …

AUTHORIZATION FOR RELEASE OF …

    https://physicians.dukehealth.org/sites/default/files/page/2019-04-01_duke_health_authorization_for_release_of_information.pdf
    SEND COMPLETED FORM TO: [email protected]; Fax: 919-620-5165 OR Duke University Hospital - HIM P.O. Box 3016 Durham, NC 27710; For …

VERBAL RELEASE OF INFORMATION …

    https://www.dukehealth.org/sites/default/files/general_page/M20UP%20044%20Verbal%20ROI%20Authorization%20Form_0.pdf
    Duke University Hospital - HIM P.O. Box 3016 Durham, NC 27710; For Questions Call: 919-684-1700. Rev. 6/19. VERBAL RELEASE OF INFORMATION AUTHORIZATION Patient …

Authorization to Release Protected Health Information

    https://www.dukehealth.org/sites/default/files/M3-13-21AuthorizationtoReleaseProtectedHealthInformation.pdf
    Authorization to Release Protected Health Information

Duke Student Affairs

    https://students.duke.edu/wellness/studenthealth/
    Release Medical Records from Duke Student Health. Students may use this form to release records to their parent or guardian. Release Medical Records to Duke …



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