AUTHORIZATION FOR EXCHANGE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION Client Patient Name: Date of Birth: - Exchange of information - Document - PDFSEARCH.IO

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	AUTHORIZATION FOR EXCHANGE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION Client/Patient Name: Date of Birth: Add to Reading List Document Date: 2013-07-16 12:17:49 Open Document File Size: 153,92 KB Share Result on Facebook

AUTHORIZATION FOR EXCHANGE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION Client/Patient Name: Date of Birth:Add to Reading List