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Get and Sign Patient Communication Consent Form Medfusion Medfusion 2014-2022

Get and Sign Patient Communication Consent Form Medfusion Medfusion 2014-2022

Use a communication consent form 2014 template to make your document workflow more streamlined.

Hwy. 121 Bedford TX. 76021 P 817-494-5000 F 817-494-5001 Patient Communication Consent Form I agree to allow Mid-Cities Family Care to contact me in the following methods regarding my private health information evaluation and treatment. I authorize Mid-Cities Family Care to leave messages for me when I am unavailable. METHOD NUMBER/ADDRESS MESSAGE Yes or No Home Phone Yes No Cell Phone Work Phone Alternate Phone Text Message Email I authorize Mid-Cities Family Care Medical Staff to discuss my...
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