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Aultman North Canton Medical Group will not use or disclose your health information for any reason unless you have signed a form authorizing us to do so. You have the right to cancel your authorization in writing unless we have taken any action in reliance on the authorization.

Please complete the Authorization for Release of Health Information form and return to:

Mail:
Medical Records Department
Aultman North Canton Medical Group
6046 Whipple Ave. NW
North Canton, OH 44720

Fax:
330-305-5014
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