I understand that by signing below, I release Graham Pediatrics of Woodstock, LLC. and its employees, agents, officers, and affiliates from any and all liability, responsibilities, claims, and damage which may result from the release of information authorized by this Authorization to Release/Request Medical Records. My child’s health care information can be disclosed as I have authorized and re-disclosed by the recipient and is no longer protected by Graham Pediatrics of Woodstock. I understand that I may revoke this authorization at any time. If not revoked earlier, this consent will remain in effect for one (1) year.