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Get and Sign Excellus Authorization to Print Out Form 2007
The child’s age, parents do not have access to
diagnosis or treatment information, including payment information, for venereal diseases, abortion, and drug
and alcohol abuse, unless the child specifically authorizes the release of such information.
As a member, you can use this form to authorize us to share your protected health information. Each person
you identify will have the same access to your information. If you would like each person to access
different information or to have access to...
Show details
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