Unc Medical Release Form. Web unc hospitals unc health information management attn: Relmedinfo@unch.unc.edu fax fax your completed authorization form to:
Medical Records Release Form Unc
The campus health medical release of information form is used for consent to sharing previous medical encounter details with campus health or transmit your campus health records. Unc medical information management attn: Web unc hospitals unc health information management attn: • i may refuse to sign this authorization: Fill in your authorization form. Click here for the spanish version. We cannot accept an electronic signature on release of information forms. Relmedinfo@unch.unc.edu fax fax your completed authorization form to: Web campus health release of information form. Unc health care system will not condition my treatment, any payment, enrollment in a health plan, or eligibility for benefits on receiving my signature on this authorization.
Web my written revocation to the medical information management department. Fill in your authorization form. University of north carolina at chapel hill. Web unc hospitals unc health information management attn: The campus health medical release of information form is used for consent to sharing previous medical encounter details with campus health or transmit your campus health records. Unc health care system will not condition my treatment, any payment, enrollment in a health plan, or eligibility for benefits on receiving my signature on this authorization. Click here for the spanish version. Under federal medical privacy law. Relmedinfo@unch.unc.edu fax fax your completed authorization form to: Web unc hospitals unc health information management attn: If you need your records released within 48 hours, a rush fee may be charged to release your records.
