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  1. www.partners.org › Assets › DocumentsMassachusetts General Hospital Medical Records Release Form

    Massachusetts General Hospital Medical Records Release Form. Mail or Fax to: Release of Information. AUTHORIZATION FOR RELEASE OF PROTECTED OR PRIVILEGED HEALTH INFORMATION. 121 Inner Belt Road, Room 240 Somerville, MA 02143-4453 Phone: 617-726-2361. FAX: 617-726-3661. For copies of radiology images or films, contact 617-726-1798 / Fax 617-724-0264

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  2. www.massgeneralbrigham.org › content › damAuthorization for Release of Protected or Privileged Health ...

    Mail or Fax Release Form To: Release of Information 121 Inner Belt Road, Room 240 Somerville, MA 02143-4453 Fax: 617-726-3661 For questions, contact: 617-726-2361. For copies of radiology images or films, contact (617) 726-1798 / Fax (617) 724-0264. Title. Massachusetts General Hospital Medical Records Release Form. Created Date.

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  4. www.massgeneral.org › hipaa-authorization-formHIPAA Authorization Form - Massachusetts General Hospital

    HIPAA Authorization for Release of Protected or Privileged Information Author: Massachusetts General Hospital. Subject: This form can be used to request release of copies of health/medical record, review of health/medical records, or to obtain copies of health/medical records from another facility. Keywords: HIPAA authorization Created Date

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  5. www.massgeneralbrigham.org › medical-recordsMedical Records | Mass General Brigham

    Request patient medical records online. You can use Patient Gateway, our secure, online portal for your health information. Your health information is available to view, download, transmit, and print documents. Once logged in, click on "Menu" at the top bar and then click "Request Records."

  6. www.massgeneral.org › notices › privacyPatient Confidentiality - Massachusetts General Hospital

    Patient Confidentiality. Massachusetts General Hospital adheres to the requirements outlined by the Health Insurance Portability and Accountability Act (HIPAA), which ensures security and privacy of an individual's medical records and promotes privacy and trust between patients and their health care providers. As part of HIPAA requirements, all ...

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  8. www.bmc.org › bmc-RequestMedicalRecords-authI hereby authorize Boston Medical Center to release my ...

    Dirección postal: Medical Record Department Fax: 617-414-4210 850 Harrison Avenue/ACC Basement Teléfono: 617-414-4213 Boston, MA 02118 Nombre del paciente:

  9. www.partners.org › Assets › DocumentsMail or Fax To: Partners Release of Information 121 Inner ...

    Partners Patient Gateway (if available) Secure Email (provide email address below) Patient Email Address: Paper Copy via Mail Fax (provide fax number): C. INFORMATION TO BE RELEASED (Please check all that apply, and specify dates): Medical Record Abstract/dates (e.g. History & Physical, Operative Report, Consults, Test