Oregon Medical Group Release Form

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Your Clinic Visit — Oregon Medical Group

https://www.oregonmedicalgroup.com/your-visit

Oregon Medical Group is committed to protecting your health information and requires a specific form completed in order to release it to you. Please download the Authorization to Use / Disclose Health Information formand return it to the front desk at any OMG clinic. Completed forms can also be faxed to us at 541-242 … See more

Oregon Medical Group

https://www.oregonmedicalgroup.com/

Oregon Medical Group has been caring for patients in Eugene, Springfield and across Lane County for more than 30 years. Our primary care doctors are supported by a talented …

Oregon.gov : State of Oregon

https://www.oregon.gov/doc/Forms/medical-records-release-form.pdf

Created Date: 3/1/2019 2:24:29 PM

Contact Us — Oregon Medical Group

https://www.oregonmedicalgroup.com/contact-us/

Northside Medical Clinic Phone:541-688-9140 Fax: 541-689-0049. Mohawk Medical Clinic Phone: 541-746-5437 Fax: 541-746-3753. Westmoreland Medical Clinic Phone: 541-686 …

Privacy Practices — Oregon Medical Group

https://www.oregonmedicalgroup.com/privacy-practices

RELEASE OF INFORMATION: Except for the uses and disclosures described and limited as set forth in this notice, Oregon Medical Group will use and disclose your …

Oregon Medical Group Authorization to Use/Disclose Health …

https://static1.squarespace.com/static/60146da9f106904d14e51ae6/t/6089c25ca20c790d63c84dc1/1619640925010/OMG+Authorization+Disclose+Medical+Information+2020.pdf

this Authorization, please send a written statement to the attention of Privacy Officer at Oregon Medical Group, P.O Box 1648 Eugene, OR. 97440, that identifies the date you …

Oregon Health Authority : Request Medical Records : …

https://www.oregon.gov/OHA/OSH/Pages/Medical-Records-Request.aspx

Send the completed forms (all pages) to: Mail Oregon State Hospital Health Information Department 2600 Center St. NE. Salem, OR 97301-2682 Fax 503-945-9855 Attn: Health …

Oregon Medical Board : Forms : State of Oregon

https://www.oregon.gov/OMB/pages/forms.aspx

Filter by form type: All Forms Types ... Oregon Medical Board 1500 SW 1st Ave., Suite 620 Portland, OR 97201-5847 Hours: 8 a.m. - 5 p.m. Closed: 12 p.m. - 1 p.m. Call Center: 9 …

Request Your Medical Records | Patients in Oregon

https://www.providence.org/about/medical-records-authorization/medical-records-or-mt

Patient Release Restriction or Revocation form. You may write a letter or complete this form to restrict the release of your protected health information, revoke a previously …

MyChart and Your Medical Record — Oregon Medical Group

https://www.oregonmedicalgroup.com/news-feed/mychart-and-your-medical-records

You will be able to access your medical record in the old portal (My ezAccess) until April 29, but you will need to sign-up for MyChart to continue to access …

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