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Get and Sign United Community Health Center Maria Auxiliadora, Inc  Form

Get and Sign United Community Health Center Maria Auxiliadora, Inc Form

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Listed below Progress Notes Consultation EKG/ECG Report ER Report Problem List Discharge Summary Radiology Report Laboratory/Pathology Medication List Immunization Report Other specify My Complete Record In addition to the general authorization to release medical records I further authorize the following information if it is contained in my record Must be initialed to authorize release Drug/Substance Abuse Diagnosis/Treatment of HIV HIV Related Illness Mental Health Sexually Transmitted Disease...
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