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Get Ocotillo Internal Medicine HIPAA Consent

E: _______________________________________ Date of Birth: ____________________ Patient information will be kept confidential except as is necessary to provide services or to ensure that all administrative matters related to your care are handled appropriately. This specifically includes the sharing of information with other healthcare providers, laboratories, health insurance payers as is necessary and appropriate for your care. Patient hereby waives his/her confidentiality rights should collect.

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