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PREGNANCY
Prenatal Care
Prenatal Education and Support
Pre-eclampsia Self-Screening
POSTPARTUM
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COVID POLICIES
RESOURCES
PREGNANCY
Prenatal Care
Prenatal Education and Support
Pre-eclampsia Self-Screening
POSTPARTUM
BABY
MENTAL WELLNESS
CONTACT
CONTACT US
CATCHMENT AREA
REQUEST A MIDWIFE
CLIENT LOGIN
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HOME
HISTORY
PICTURES
REVIEWS
MIDWIVES
Administrative Staff
Midwifery Students
BIRTHPLACE
CARE
FAQS
COVID-19
COVID POLICIES
RESOURCES
PREGNANCY
Prenatal Care
Prenatal Education and Support
Pre-eclampsia Self-Screening
POSTPARTUM
BABY
MENTAL WELLNESS
CONTACT
CONTACT US
CATCHMENT AREA
REQUEST A MIDWIFE
CLIENT LOGIN
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Welcome to Lincoln Community Midwives
Release of Information
Dear:
Fax Number:
I am currently a patient under the care of the midwives at Lincoln Community Midwives. I hereby request that my medical records (as outlined below) be released to Lincoln Community Midwives as soon as possible. The records you can provide will be invaluable. I thank you for your assistance in this matter.
I understand the purpose for disclosing this personal health information to the Lincoln Community Midwives. I understand that I can refuse to sign this consent form.
By filling out this form and clicking on "Submit", I am
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