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Get Quest Diagnostics Authorization Form

May pertain to my diagnosis and treatment , laboratory test results, medical history, billing information, ordering and treating physicians and other related information, including but not limited to HIV and drug testing information) as specifically identified in the original subpoena attached to this authorization and to the person(s) named in the subpoena (Photocopies, facsimile transmissions, and similar non-original versions of the subpoena are unacceptable). This authorization will expire.

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