div class=ts-pagebuttonPage 1button div class=ts-image amp-img class=ts-thumb alt=Page 1: MicrosoftNEW 1 Authorization: I authorize disclosure of medical information and health records as described below Name of Patient: Social Security Number: 2 Record-Holderu Optional src=https:reader034vdocumentsusreader034viewer20220518136032fdca72ea8978d67e28c3html5thumbnails1jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 2button div class=ts-image amp-img class=ts-thumb alt=Page 2: MicrosoftNEW 1 Authorization: I authorize disclosure of medical information and health records as described below Name of Patient: Social Security Number: 2 Record-Holderu Optional src=https:reader034vdocumentsusreader034viewer20220518136032fdca72ea8978d67e28c3html5thumbnails2jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 3button div class=ts-image amp-img class=ts-thumb alt=Page 3: MicrosoftNEW 1 Authorization: I authorize disclosure of medical information and health records as described below Name of Patient: Social Security Number: 2 Record-Holderu Optional src=https:reader034vdocumentsusreader034viewer20220518136032fdca72ea8978d67e28c3html5thumbnails3jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 4button div class=ts-image amp-img class=ts-thumb alt=Page 4: MicrosoftNEW 1 Authorization: I authorize disclosure of medical information and health records as described below Name of Patient: Social Security Number: 2 Record-Holderu Optional src=https:reader034vdocumentsusreader034viewer20220518136032fdca72ea8978d67e28c3html5thumbnails4jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 5button div class=ts-image amp-img class=ts-thumb alt=Page 5: MicrosoftNEW 1 Authorization: I authorize disclosure of medical information and health records as described below Name of Patient: Social Security Number: 2 Record-Holderu Optional src=https:reader034vdocumentsusreader034viewer20220518136032fdca72ea8978d67e28c3html5thumbnails5jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 6button div class=ts-image amp-img class=ts-thumb alt=Page 6: MicrosoftNEW 1 Authorization: I authorize disclosure of medical information and health records as described below Name of Patient: Social Security Number: 2 Record-Holderu Optional src=https:reader034vdocumentsusreader034viewer20220518136032fdca72ea8978d67e28c3html5thumbnails6jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 7button div class=ts-image amp-img class=ts-thumb alt=Page 7: MicrosoftNEW 1 Authorization: I authorize disclosure of medical information and health records as described below Name of Patient: Social Security Number: 2 Record-Holderu Optional src=https:reader034vdocumentsusreader034viewer20220518136032fdca72ea8978d67e28c3html5thumbnails7jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 8button div class=ts-image amp-img class=ts-thumb alt=Page 8: MicrosoftNEW 1 Authorization: I authorize disclosure of medical information and health records as described below Name of Patient: Social Security Number: 2 Record-Holderu Optional src=https:reader034vdocumentsusreader034viewer20220518136032fdca72ea8978d67e28c3html5thumbnails8jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 9button div class=ts-image amp-img class=ts-thumb alt=Page 9: MicrosoftNEW 1 Authorization: I authorize disclosure of medical information and health records as described below Name of Patient: Social Security Number: 2 Record-Holderu Optional src=https:reader034vdocumentsusreader034viewer20220518136032fdca72ea8978d67e28c3html5thumbnails9jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 10button div class=ts-image amp-img class=ts-thumb alt=Page 10: MicrosoftNEW 1 Authorization: I authorize disclosure of medical information and health records as described below Name of Patient: Social Security Number: 2 Record-Holderu Optional src=https:reader034vdocumentsusreader034viewer20220518136032fdca72ea8978d67e28c3html5thumbnails10jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 11button div class=ts-image amp-img class=ts-thumb alt=Page 11: MicrosoftNEW 1 Authorization: I authorize disclosure of medical information and health records as described below Name of Patient: Social Security Number: 2 Record-Holderu Optional src=https:reader034vdocumentsusreader034viewer20220518136032fdca72ea8978d67e28c3html5thumbnails11jpg width=142 height=106 layout=responsive amp-img divdiv