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Get Orthopaedic Center Patient Authorization For Treatment And Release Of Information

Understand that as a part of my electronic health record, The Orthopaedic Center will transmit my prescriptions electronically as permitted, to the pharmacy that I designate as my primary pharmacy provider. Additionally, The Orthopaedic Center will obtain the history of all of my past prescriptions dating back two years from pharmacy benefit managers and I understand that those prescriptions will become a part of my electronic health record. By signing below I hereby give consent to the above a.

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