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Get Blank Hipaa Authorization Form

R Notice of Privacy Practices provides information about how we may use and disclose protected health information about you. The Notice contains a Patient Rights section describing your rights under the law. You have the right to review our Notice before signing this Consent. The terms of our Notice may change. If we change ou Notice, you may obtain a revised copy by contacting our offlce. You have the right to request that we resftict how protected health information about you is used or discl.

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