div class=ts-pagebutton class=gotoPage data-page=1Page 1button div class=ts-imageimg data-url=release-of-medical-records-i-hereby-authorize-dr-aydin-to-release-my-medicalhtmlpage=1 data-page=1 class=ts-thumb lazyload alt=Page 1: €¦ · *RELEASE OF MEDICAL RECORDS: I hereby authorize Dr Aydin to release my medical information to my insurance company if requested Signature PATIENT IS A MINOR: I give permission loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader034vdocumentssitereader034viewer20220423085ed48d293d6f7d64f9067891html5thumbnails1jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=2Page 2button div class=ts-imageimg data-url=release-of-medical-records-i-hereby-authorize-dr-aydin-to-release-my-medicalhtmlpage=2 data-page=2 class=ts-thumb lazyload alt=Page 2: €¦ · *RELEASE OF MEDICAL RECORDS: I hereby authorize Dr Aydin to release my medical information to my insurance company if requested Signature PATIENT IS A MINOR: I give permission loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader034vdocumentssitereader034viewer20220423085ed48d293d6f7d64f9067891html5thumbnails2jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=3Page 3button div class=ts-imageimg data-url=release-of-medical-records-i-hereby-authorize-dr-aydin-to-release-my-medicalhtmlpage=3 data-page=3 class=ts-thumb lazyload alt=Page 3: €¦ · *RELEASE OF MEDICAL RECORDS: I hereby authorize Dr Aydin to release my medical information to my insurance company if requested Signature PATIENT IS A MINOR: I give permission loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader034vdocumentssitereader034viewer20220423085ed48d293d6f7d64f9067891html5thumbnails3jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=4Page 4button div class=ts-imageimg data-url=release-of-medical-records-i-hereby-authorize-dr-aydin-to-release-my-medicalhtmlpage=4 data-page=4 class=ts-thumb lazyload alt=Page 4: €¦ · *RELEASE OF MEDICAL RECORDS: I hereby authorize Dr Aydin to release my medical information to my insurance company if requested Signature PATIENT IS A MINOR: I give permission loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader034vdocumentssitereader034viewer20220423085ed48d293d6f7d64f9067891html5thumbnails4jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=5Page 5button div class=ts-imageimg data-url=release-of-medical-records-i-hereby-authorize-dr-aydin-to-release-my-medicalhtmlpage=5 data-page=5 class=ts-thumb lazyload alt=Page 5: €¦ · *RELEASE OF MEDICAL RECORDS: I hereby authorize Dr Aydin to release my medical information to my insurance company if requested Signature PATIENT IS A MINOR: I give permission loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader034vdocumentssitereader034viewer20220423085ed48d293d6f7d64f9067891html5thumbnails5jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=6Page 6button div class=ts-imageimg data-url=release-of-medical-records-i-hereby-authorize-dr-aydin-to-release-my-medicalhtmlpage=6 data-page=6 class=ts-thumb lazyload alt=Page 6: €¦ · *RELEASE OF MEDICAL RECORDS: I hereby authorize Dr Aydin to release my medical information to my insurance company if requested Signature PATIENT IS A MINOR: I give permission loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader034vdocumentssitereader034viewer20220423085ed48d293d6f7d64f9067891html5thumbnails6jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=7Page 7button div class=ts-imageimg data-url=release-of-medical-records-i-hereby-authorize-dr-aydin-to-release-my-medicalhtmlpage=7 data-page=7 class=ts-thumb lazyload alt=Page 7: €¦ · *RELEASE OF MEDICAL RECORDS: I hereby authorize Dr Aydin to release my medical information to my insurance company if requested Signature PATIENT IS A MINOR: I give permission loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader034vdocumentssitereader034viewer20220423085ed48d293d6f7d64f9067891html5thumbnails7jpg width=140 height=200 divdiv
