Patient Registration Form - Granger Medical Granger Medical makes every effort to use your preferred method of communication for billing appointment treatment reminders or any other issues regarding your account and service From time to time, we offer updates on our clinics, new medical treatments and procedures or send satisfaction surveys about your care and our providers
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Patient Services - Granger Medical Clinic If you need to download our Medical Records Release Form, you can access it here: [Medical Records Release of Information Form] Please complete the form and return it along with a copy of your photo ID via fax to 801 965 3537 or by email at medrecrequest@grangermedical com
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Patient Registration Form - Granger Medical Medical release and consent to treat I hereby consent to medical treatment, diagnostic tests, laboratory or other procedures, which the physician(s) or other health care provider(s) of Granger Medical Clinic may consider or advise in my treatment, or in treatment of my dependent
GRANGER MEDICAL WEST VALLEY: 3725 West 4100 South, West Valley City, UT . . . Sexually Transmitted Disease testing results or AIDS information INITIALS: ___________ This authorization is valid for 1 year from the date of signing, and may be revoked at any time by sending a written request to the facility releasing your