Banner University Medical Center Tucson Medical Records Fax Numberx Raw Image4a63536e421b94805a9be74116f28ec9908b213f71b759b6fa68cbe024cde0adx Raw Image867dfda9c89596eb8699ae7f4523cd1a4388b4625a25cca9e46c66310dffac39x Raw Image6d9805e54363ce9ef3be6a78b9caaeb8737e625850f358e0ddf3cbbd989c0b75x Raw Image6d9805e54363ce9ef3be6a78b9caaeb8737e625850f358e0ddf3cbbd989c0b75
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Banner University Medical Center • Tucson, AZ | TBCx | Total Building Commissioning JFK University Medical Center. MEDICAL RECORDS RELEASE Pa�ent Name: DOB: I authorize the following custodian/en�ty to release the requested Medical Recor.
Banner University Medical Center Tucson Medical Records Fax Numberx Raw Image4a63536e421b94805a9be74116f28ec9908b213f71b759b6fa68cbe024cde0adx Raw Image867dfda9c89596eb8699ae7f4523cd1a4388b4625a25cca9e46c66310dffac39x Raw Image6d9805e54363ce9ef3be6a78b9caaeb8737e625850f358e0ddf3cbbd989c0b75x Raw Image6d9805e54363ce9ef3be6a78b9caaeb8737e625850f358e0ddf3cbbd989c0b75
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Banner University Medical Center • Tucson, AZ | TBCx | Total Building Commissioning
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Banner University Medical Center Tucson Medical Records Fax Numberx Raw Image4a63536e421b94805a9be74116f28ec9908b213f71b759b6fa68cbe024cde0adx Raw Image867dfda9c89596eb8699ae7f4523cd1a4388b4625a25cca9e46c66310dffac39x Raw Image6d9805e54363ce9ef3be6a78b9caaeb8737e625850f358e0ddf3cbbd989c0b75x Raw Image6d9805e54363ce9ef3be6a78b9caaeb8737e625850f358e0ddf3cbbd989c0b75
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MEDICAL RECORDS RELEASE Pa�ent Name: DOB: I authorize the following custodian/en�ty to release the requested Medical Recor
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