• Medical Records Release Authorization

    Please use this form in order to provide Orthopedic Associates records to an outside company or person.
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  • Upon presentation of this authorization you are requested to provide the records outlined below to:

  • Records will be sent from

    Orthopedic Assocaites of Flower Mound and Denton
    5000 Long Prairie Road, Suite 100
    Flower Mound, TX 75028

    Phone: (972)420-1776
    Fax: (214)222-6660

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  • Please indicate your acceptance by checking the following boxes:

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