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Surf and Sand Pediatrics

Phone 9124563605 Fax 9124563531

Email: salina@surfandsandpediatrics.com

Release of Medical Information 

Patient Date Of Birth
Month
Day
Year
Authorization to Disclose
Reason for records release request:
Transfer of care
Self
Specialist
Other
Records Requested
Medical records from last 2 years
Complete Medical record content
Limited records from specific date:
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