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Authorization for Release of Dental Information This authorization for the use or release of medical information is requested from you in order to comply with the requirements of California Civil Code Section 56, et seq.
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Document Date: 2014-07-24 18:43:10
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Authorization for Release of Dental Information This authorization for the use or release of medical information is requested from you in order to comply with the requirements of California Civil Code Section 56, et seq.