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Get AZ Marijuana Doctor Intake Form Packet 2018

Se or disclose protected health information. The notice contains a patient s rights section describing your rights under the law. You ascertain that by your signature that you have reviewed our notice before signing this consent. The terms of the notice may change, if so, you will be notified at your next visit to update your signature/date. You have the right to restrict how your protected health information is used and disclosed for treatment, payment or healthcare operations. We are not req.

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