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Get BHSF 6001 2013

R 10 days G Paper or G Electronic: G email G USB Drive G CD Availability of electronic format depends on date facility started storing electronic data I hereby authorize the use and/or disclosure of the below named individual’s health information as described below: 1. I hereby authorize the following individual(s) or organization(s): G Baptist Hospital of Miami G South Miami Hospital G Doctors Hospital G Homestead Hospital G West Kendall Baptist Hospital G Baptist Outpatient Services G Ambu.

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