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ENGLISH

PATIENT REGISTRATION
CONSENT TO TREAT
ACKNOWLEDGMENT OF RECEIPT OF NOTICE OF PRIVACY OF PRACTICES
AUTHORIZATION FOR RELEASE OF MEDICAL RECORDS

ESPAÑOL

REGISTRO DEL PACIENTE
CONSENTIMIENTO PARA TRATAMIENTO
RECONOCIMIENTO DE RECIBO DEL AVISO DE PRIVACIDAD DE PRÁCTICAS
AUTORIZACIÓN PARA LA DIVULGACION DE REGISTROS MÉDICOS

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