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This request form should not be used for patients and their legal representatives requesting medical records, please visit (debbieharrington.com/patient-information/release-medical-records) for medical records requests.
ATTENTION: This form is a request for machine/computer-readable format only.
This should not be used for patients and their legal representatives to request copies of medial records. To request copies of your medical records, please visit the Release of Information page.
Questions? Call 866-609-4357. For patients 877-778-7211
