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HIPAA RELEASE AND AUTHORIZATION I, ADULT CHILD DOE, residing at _____________________ authorize any physician, health-care professional, treatment center, dentist, health plan, hospital, clinic, laboratory, pharmacy or o
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Document Date: 2017-06-26 17:47:58
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HIPAA RELEASE AND AUTHORIZATION I, ADULT CHILD DOE, residing at _____________________ authorize any physician, health-care professional, treatment center, dentist, health plan, hospital, clinic, laboratory, pharmacy or o