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    • Home
    • About Us
      • Eleanor Sullivan
      • Our Staff
      • Our Doctrine
      • What is a Cardiologist
      • Financial Policies
    • Video
      • Relaxation and Breathing
      • Steps to Prevent COVID-19
      • Cardiovascular Wellness
    • Testing
      • Echocardiograms
      • EKG and ECG
      • Stress Test
    • Patient Resources
      • COVID-19
      • Stress Test Instructions
      • Record Release
      • Prescription Refills
    • Insurance Policy
    • TeleVisits
    • Patient Portal
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  • Home
  • About Us
    • Eleanor Sullivan
    • Our Staff
    • Our Doctrine
    • What is a Cardiologist
    • Financial Policies
  • Video
    • Relaxation and Breathing
    • Steps to Prevent COVID-19
    • Cardiovascular Wellness
  • Testing
    • Echocardiograms
    • EKG and ECG
    • Stress Test
  • Patient Resources
    • COVID-19
    • Stress Test Instructions
    • Record Release
    • Prescription Refills
  • Insurance Policy
  • TeleVisits
  • Patient Portal

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RECORD RELEASE FORM

When transferring care to a new provider you will need to send to us a completed record release form.  You may download, print, and fill out the form below prior to your visit to your new provider so that we may send them your records. 

Record Release (pdf)Download

125 UNDERPASS ROAD, BREWSTER, MA 02631   TELEPHONE: (508) 876-3777   FAX:  (888) 275-9498

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