Unc Medical Release Form. Unc medical information management attn: Web unc hospitals unc health information management attn:
Unc Health Care Medical Records Release Form
The authorization form can be obtained from any unc hospitals, unc hillsborough campus or chatham hospital, or you can download a copy from the link. Web to release the protected health information of the patient named above to: Fill in your authorization form. Click here for the spanish version. Web patient information release forms for public relations and medical purposes are now available via the intranet’s “forms” page. Web unc hospitals unc health information management attn: Unc health care system will not condition my treatment, any payment, enrollment in a health plan, or eligibility for benefits on receiving my signature on this authorization. Unc medical information management attn: These forms can be found via the “ forms ” link on the intranet home page. University of north carolina at chapel hill.
Web unc hospitals unc health information management attn: Web unc hospitals unc health information management attn: Relmedinfo@unch.unc.edu fax fax your completed authorization form to: Click here for the english release form. Web to release the protected health information of the patient named above to: • i may refuse to sign this authorization: Web unc hospitals unc health information management attn: University of north carolina at chapel hill. The campus health medical release of information form is used for consent to sharing previous medical encounter details with campus health or transmit your campus health records. Unc health care system will not condition my treatment, any payment, enrollment in a health plan, or eligibility for benefits on receiving my signature on this authorization. Unc medical information management attn:
