Tully Hill Release of Information
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Download and complete the form above. Save and submit.
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The uploading, storage, and access of your records is completely secure and 100% HIPPA-compliant.
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Having JAVA or FLASH running on your device will better ensure successful execution of your upload.
Can’t upload your file(s)?
Fax them to us at 315-413-5106 (e-fax)
or 315-696-8509 (standard fax)