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  • Release of Medical Information

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  • Statement

    I hereby authorize the release of my medical information and records related to my medical history, treatment, and current condition to Dr Rebecca Ryan.This authorization includes, but is not limited to, information related to my diagnosis, treatment, medications, lab results, x-rays, and any other medical records deemed necessary by the doctor/medical facility. I understand that the information being released is confidential and may be protected by federal and state laws.I understand that I have the right to revoke this authorization at any time, except to the extent that action has already been taken in reliance on it.
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  • Information Required

    • Correspondance
    • Gastroscopy Report
    • Colonoscopy Report
    • Histology
    • Anal Manometry
    • ECHO
    • Holter Monitor 

    Information to be sent to:

    Dr Rebecca Ryan 226695MJ
    Phone: (07) 5391 1311
    Fax: (07) 5613 1881
    Email: info@drrebeccaryan.com.au
    Preferred method of transfer: Medical Objects

     

     

     

     

     

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