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Get Sanford Adult/Teen Proxy Form 2011

At My Sanford Chart is intended as a secure online source of confidential medical information. If I share My Sanford Chart ID and password with another person, that person may be able to view my health information or my child’s health information, and health information about anyone who has authorized me as a My Sanford Chart proxy. I understand that the information in My Sanford Chart may include billing information associated with my account. I agree that it is my responsibility to select a .

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