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BERNARD SANDERS DDS 19931 W. 12 MILE RD. SOUTHFIELD, MI 48076 NOTICE OF USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION THIS NOTICE DESCRIBES HOW MEDICAL INFORMATIONABOUOT YOU MAY BE USED AND DISCLOSED

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1. Begin by carefully reading the instructions provided with the form. Understanding the requirements and specific sections of the form is crucial to ensure accurate completion.
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1. Dental professionals: Dentists who are registered or licensed to practice dentistry may need to fill out the bernard sanders dds 19931 form. This may include general dentists, orthodontists, oral surgeons, and other dental specialists.
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