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Es Center (or the releasing facility). Information may be released until my written notice of cancellation is received. This Authorization expires 180 days from the date signed or on the following date or event (specify) Additional information is in TTUHSC s Notice of Privacy Practice. If the healthcare services are being provided at the request of and being paid for by my employer (or prospective employer), I understand and agree that all records and information related to the hea.

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