Authorization for Release
To send via fax or mail, please download, print and complete the Authorization for Release form:
11365 Dorsett Road
Maryland Heights, MO 63043
To: Ranken Jordan
Please note that Ranken Jordan HIM can only provide a copy of the information on file. We cannot interpret what the information means or discuss it with you. If you had additional questions about the content of the records, we encourage you to contact your doctor or the treating physician.
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