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Primary Care Partners AUTHORIZATION TO USE AND/OR DISCLOSE HEALTH INFORMATION Authorization. The undersigned hereby authorizes Primary Care Partners and its employees to use and/or disclose the following
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Provide your personal information such as your name, address, contact details, and date of birth.
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Individuals residing in or near the South Lincoln area who require primary medical care.
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South Lincoln Family Physicians is a medical practice that provides healthcare services to families in the Lincoln area.
Patients who receive medical services from South Lincoln Family Physicians are required to file the necessary documents.
To fill out South Lincoln Family Physicians forms, patients need to provide their personal information, medical history, and insurance details.
The purpose of South Lincoln Family Physicians is to provide quality healthcare services to families in the Lincoln area.
Patients must report their personal information, medical history, and insurance details on South Lincoln Family Physicians forms.
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