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Authorization for Release of Medical Information

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Signed by New Horizon Wellness Clinics
Signed On: July 11, 2024

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June 27, 2024 11:07 EDT

Authorization for Release of Medical Information Uploaded by New Horizon Wellness Clinics - records@newhorizonclinics.com IP 68.204.70.116

June 28, 2024 11:21 EDT

Records New Horizon Clinics - records@newhorizonclinics.com added by Joann Wagner - leaw@mmtcfl.com as a CC'd Recipient Ip: 76.210.32.60

June 28, 2024 23:58 EDT

Records New Horizon Clinics - records@newhorizonclinics.com added by Joann Wagner - leaw@mmtcfl.com as a CC'd Recipient Ip: 68.204.70.116

June 29, 2024 00:18 EDT

Records New Horizon Clinics - records@newhorizonclinics.com added by Joann Wagner - leaw@mmtcfl.com as a CC'd Recipient Ip: 68.204.70.116

July 1, 2024 11:00 EDT

Records New Horizon Clinics - records@newhorizonclinics.com added by Joann Wagner - leaw@mmtcfl.com as a CC'd Recipient Ip: 76.210.32.60

July 1, 2024 21:42 EDT

Records New Horizon Clinics - records@newhorizonclinics.com added by Joann Wagner - leaw@mmtcfl.com as a CC'd Recipient Ip: 68.204.70.116

July 1, 2024 21:43 EDT

Records New Horizon Clinics - records@newhorizonclinics.com added by Joann Wagner - leaw@mmtcfl.com as a CC'd Recipient Ip: 68.204.70.116

July 2, 2024 09:25 EDT

Records New Horizon Clinics - records@newhorizonclinics.com added by Joann Wagner - leaw@mmtcfl.com as a CC'd Recipient Ip: 76.210.32.60

July 2, 2024 09:27 EDT

Records New Horizon Clinics - records@newhorizonclinics.com added by Joann Wagner - leaw@mmtcfl.com as a CC'd Recipient Ip: 76.210.32.60

July 2, 2024 18:16 EDT

Document owner leaw@mmtcfl.com has handed over this document to records@newhorizonclinics.com 2024-07-02 18:16:22 - 68.204.70.116

July 2, 2024 18:16 EDT

Records New Horizon Clinics - records@newhorizonclinics.com added by New Horizon Infustion Ketamine Clinic - records@newhorizonclinics.com as a CC'd Recipient Ip: 68.204.70.116

July 2, 2024 18:32 EDT

Document owner ixxigolfer@gmail.com has handed over this document to noreply@newhorizonclinics.com 2024-07-02 18:32:31 - 68.204.70.116

July 2, 2024 18:32 EDT

Records New Horizon Clinics - records@newhorizonclinics.com added by Marc Matoza - noreply@newhorizonclinics.com as a CC'd Recipient Ip: 68.204.70.116

July 2, 2024 18:35 EDT

Records New Horizon Clinics - records@newhorizonclinics.com added by New Horizon Wellness Clinics - records@newhorizonclinics.com as a CC'd Recipient Ip: 68.204.70.116