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Texas Medical Records Request Form – Provider

Fax Cover sheet and Records Request letter sent to health care providers from whom the patient in question may have received services, including prenatal care, postpartum care, general or specialty medicine care, and visits to allied health services providers.
Year of publication and/or last update:
2016
Source:
Texas Department of State Health Services
Resource Type Tags:
Templates
Review Stage Tags:
Case Abstraction
Case Identification
Case Selection
Role Tags:
Case Abstractor