Find Laws Find Lawyers Free Legal Forms USA State Laws

ALABAMA STATUTES AND CODES

Section 12-21-7 Copy of hospital records - Certificate of custodian.

Section 12-21-7

Copy of hospital records - Certificate of custodian.

The certificate of the custodian of the hospital records provided for in Sections 12-21-5 and 12-21-6 shall show the name of the parties to the case or proceeding and the name of the court to which made, by appropriate caption, and said certificate shall be in form in substance as follows, to-wit:

I, _____, hereby certify and affirm in writing that I am _____ of the _____ Hospital, a hospital organized or operated pursuant to or under the laws of Alabama, located at _____, Alabama, that I am custodian of the hospital records of said hospital and that the within copy of said hospital records are an exact, full, true and correct copy of said hospital records pertaining to _____.

I further certify that I am familiar with and know, and knew when made and charged, the reasonable value and price for the various charges made and shown in said hospital records pertaining to _________ and that said charges are in my judgment just, reasonable and proper and in keeping with those generally charged in the county and community where said hospital is located.

All of which I hereby certify and affirm on this ______ day of __________, 19__.

(Acts 1965, 2nd Ex. Sess., No. 77, p. 102, §3.)

Alabama Forms by Issue

Alabama Court Forms
> Claims
Alabama Divorce Forms
Alabama Environmental Forms
Alabama Marriage Forms
Alabama Name Change Forms
Alabama Other Forms
Alabama Retirement Forms
Alabama Tax Forms

Alabama Law

Alabama State Laws
    > Alabama Child Support
    > Alabama Gun Law
    > Alabama Statute
Alabama Tax
    > Alabama State Tax
Alabama Agencies
    > Alabama Department of Corrections
    > Alabama Department of Education
    > Alabama Department of Revenue
    > Alabama Department of Transportation
    > Alabama DMV
    > Alabama Medicaid
    > Alabama Secretary of State

Alabama Court Map

Tips