Medical Information release

Release of Medical Information

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Consent To Release

Your consent is required for the release of medical or confidential information.

I hereby authorise the release of copies of my medical documentation and other personal information, for the purpose of ongoing treatment, to the following parties:

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I consent the release of my medical information to Camberwell Sports & Spinal Medicine.I consent Camberwell Sports and Spinal Medicine to release my medical information to other parties.

I acknowledge that I understand the purpose of the request and the authorisation is hereby granted voluntarily.

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