Consent and Authorization. I hereby consent to the release by Hospital to Requester of any and all information, records and/or documents in the possession of Hospital, in whatever form or medium whether verbally, electronically and/or in writing relating to my residency or fellowship performance at Hospital. I further consent to Hospital’s release of supplemental information relating to my residency or fellowship performance from time to time in connection with an initial request for information from Requester to ensure the information provided by Hospital to Requestor in reliance on this authorization is more complete, accurate, or timely.
Appears in 2 contracts
Sources: Graduate Medical Education Contract, Graduate Medical Education Resident Agreement