Release of Medical records

Release of Medical Records

Sepia Modern Primary Care
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I am presently a patient of Serina Lewis, MD and do hereby authorize the release of my medical records
All medical recordsOnly medical records from selected datesOther
Specific form in request
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Please send correspondence to:

Sepia Modern Primary Care

757 Frederick Rd Suite 204, Catonsville, MD 21228

P: 410-929-1335

F: 301-235-1551

email: admin@sepiamodernprimarycare.com
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Release of Medical Records