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6 2x 3 2 2x 1 Expand
6 2x 3 2 2x 1 Expand
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6 2x 3 2 2x 1 ExpandHIPAA Forms1. Authorization for Use and Disclosure of Health Information for Research2. Combined Informed Consent/Authorization Template3. Authorization ... I or my authorized representative request that health information regarding my care and treatment be released as set forth on this form
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