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Forms for PHI from a Pharmacy

Costco Health Centers Authorization for the Release of PHI

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CVS/caremark Authorization for One-Time Written Release of PHI

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Walgreens Authorization for Release of Information to a Third Party

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Walmart Authorization to Release PHI

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Meijer Pharmacy Authorization to Release PHI

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Rite Aid Attorney Authorization

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All records we receive are checked for accuracy and distributed within 24 hours of receipt. Records are sent over a secure online repository, or you can have them printed and professionally bound.

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