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Chiropractor Blanket Patient Authorization Form

Chiropractors, buy this ready-to-use Blanket Patient Authorization form for your patients to fill out.

The patient would complete the form to give a general or "blanket" direction to any and all medical, paramedical and health services facilities, authorizing them to release whatever information they may have on file with respect to injuries the patient has sustained. The information is to be released to the chiropractor, for treatment purposes.

This Chiropractor Blanket Patient Authorization Form is available in MS Word format, and can be easily edited to fit your business needs.

Download: Chiropractor Blanket Patient Authorization Form

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Canadian Law Resources: (14-Apr-2018) E.&O.E.

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