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Records Release Form | SmartPractice Dental
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California Authorization for the Release of Dental Records I hereby authorize DDS/DMD to release inf
Release Consent Form copy - Dental Records and X-RAY Release Form I,____Gabriel M - Studocu
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Garrett S. Dennis D.M.D. AUTHORIZATION FOR RELEASE AND TRANSFER OF DENTAL RECORDS
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Dental Records Release Form
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Record Release Form hereby authorize ( Patient's Name) (Former Dentist's Name) to provide --------------------------------------
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