Release of Records: Authorization for release of medical/dental information

I authorize the release of records to Or. Malekzadeh, including those that may contain confidential HIV/AIDS-related information, confidential communicable disease-related information, and information relating to mental health and/or alcohol/drug use. Please release the following records:
# Laboratory Reports
# Xray, MRI, Cat Scan Reports
# Progress Notes
# Medication List
# Complete Record
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