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To serve you better, we may be required by a medical provider to obtain a MAP Release of Information Form (Adobe Acrobat Reader required), which allows your MAP representative to request/release copies of your medical records to authorized providers. All MAP requests for information comply with HIPAA privacy procedures.

Should your MAP healthcare representative request you to fill out the release form, simply download it by clicking on the link above, fill out the necessary information and FAX it directly to Delphi corporate headquarters at (727) 561.0732.