I authorize Childrens Cardiovascular Medicine to release my medical records to:
All medical sources, including any health plan, physician, health care professional, hospital, clinic, laboratory, pharmacy, medial facility, or other health care provider that has provided payment, treatment or services to me or on my behalf
This authorization,as may be. applicable, extends to any medical records covered by any privilege, including without limitation to psychiatric, psychological and mental and records; records relating to drug treatment and/or substance abuse; records related to sexually transmitted diseases and/or social service notes.