HIPAA - A One Dental And Implant Center

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I have had full opportunity to read and consider the contents of the Notice of Privacy Practices. I understand that I am giving my permission to your use and disclosure of my protected health information in order to carry out treatment, payment activities, and healthcare operations. I also understand that I have the right to revoke permission.By checking this box and submitting your information, you are granting us permission to email you. You may unsubscribe at any time.

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