Emed Multispecialty Group

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P: (904) 513-3240

F: (904) 398-7871
2624 Atlantic Blvd
Jacksonville, FL 32207

Medical Release Form

Hi, this is Dr. Pulido. On this page you’ll find a downloadable medical release form you can download, print out, and sign to give to any other doctors that may need to share protected health information with us. This form gives them permission to share HIPAA protected information with us across a secure