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Get UAB Health System Authorization For Use Or Disclosure Of Information 2014

__ NOTICE: If I request records in electronic form, I understand that the records on the CD or available via email/secured portal will be encrypted to help protect my privacy and the security of my health records and that I will be furnished with the manner in which to access those encrypted records. UAB Health System is not responsible for the privacy and security of the electronic records on the CD or in an email once they are received by the intended recipient. F# 245r11 (Ref HA# 18 & 20) D.

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