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/Personal Representative Relationship to Patient Witness Re-disclosure: Notice is hereby given to the patient or legal representative signing this Authorization that Dreyer Medical Clinic and Advocate Health Care cannot guarantee that the Recipient receiving the requested health information will not re-disclose any or all of it to others. Notice is hereby given to the Recipient that law prohibits the re-disclosure of any health information regarding drug and/or alcohol abuse, HIV, and mental.

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