51![PRIVACY NOTICE OF THE CITY OF HUNTSVILLE EMPLOYEE CLINIC THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. PRIVACY NOTICE OF THE CITY OF HUNTSVILLE EMPLOYEE CLINIC THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.](https://www.pdfsearch.io/img/53f72b65b339909fc9e269b39fc064f7.jpg) | Add to Reading ListSource URL: www.hsvcity.comLanguage: English - Date: 2013-09-23 17:03:00
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52![Computer Access Request Form Please write legibly and fill out completely **Required for health personnel only Personal Information Last: Computer Access Request Form Please write legibly and fill out completely **Required for health personnel only Personal Information Last:](https://www.pdfsearch.io/img/2796e40280af5a90f9a9ae83ca8a9215.jpg) | Add to Reading ListSource URL: karuk.usLanguage: English - Date: 2015-12-22 12:50:33
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53![*3ROI* 3ROI Note: Fees may apply to certain requests Use or Disclosure: I hereby authorize (select appropriate JMH entity or location below): *3ROI* 3ROI Note: Fees may apply to certain requests Use or Disclosure: I hereby authorize (select appropriate JMH entity or location below):](https://www.pdfsearch.io/img/eb46aa4456701757e3f6d16b3f6ce9b4.jpg) | Add to Reading ListSource URL: www.johnmuirhealth.comLanguage: English - Date: 2016-08-22 19:34:43
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55![IRB MED CONTINUING REVIEW FORM Continuing Review Form: IRB MED CONTINUING REVIEW FORM Continuing Review Form:](https://www.pdfsearch.io/img/c8c224a54b6685f9c9dbdad0d56445d7.jpg) | Add to Reading ListSource URL: humansubjects.stanford.eduLanguage: English - Date: 2016-04-12 01:21:51
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58![Dr.
Ronald
E.
Terry
Family
Dentistry
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Responsibility
Agreement
Patient
responsibility
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is
due
at
time
of
service
We
have
Dr.
Ronald
E.
Terry
Family
Dentistry
Patient
Responsibility
Agreement
Patient
responsibility
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is
due
at
time
of
service
We
have](https://www.pdfsearch.io/img/4736b8e73667cb8e9820ba1beaca3e84.jpg) | Add to Reading ListSource URL: terrydentistry.comLanguage: English - Date: 2013-12-26 15:48:25
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59![BOONE COUNTY, MISSOURI MENTAL HEALTH COURT CONSENT TO RELEASE INFORMATION I, _______________________________________ (client), authorize the Thirteenth Judicial Circuit Court of Boone County, Missouri and the Boone Count BOONE COUNTY, MISSOURI MENTAL HEALTH COURT CONSENT TO RELEASE INFORMATION I, _______________________________________ (client), authorize the Thirteenth Judicial Circuit Court of Boone County, Missouri and the Boone Count](https://www.pdfsearch.io/img/da7b8471136c55c00913571e2edc1313.jpg) | Add to Reading ListSource URL: www.courts.mo.govLanguage: English - Date: 2016-08-22 11:18:41
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60![Notice of Privacy Practices THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION PLEASE READ IT CAREFULLY The Health Insurance Portability & Acc Notice of Privacy Practices THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION PLEASE READ IT CAREFULLY The Health Insurance Portability & Acc](https://www.pdfsearch.io/img/c131b1f381894226f66fca4d3dd797a1.jpg) | Add to Reading ListSource URL: asc-derm.comLanguage: English - Date: 2015-08-14 07:13:31
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