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Upper East Side Gynecology Record Release Form:


                                             Authorization to Release Medical Records


**After the forms are filled out, you may fax it back to us at 212-988-8737 or email it to our HIPAA Secure email (reception@uesgyn.com).

Please note this email is ONLY intended for record release request forms, not medical questions for the doctors as they do not see these emails.

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