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Physician Authorization Form Organization Print Name Signature Date My signature above confirms that all of my patients whose samples are sent to Nat era for testing will have given informed consent
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What is my signature above confirms?
My signature above confirms that I have reviewed and agreed to the contents of the document.
Who is required to file my signature above confirms?
The individual whose signature is above confirms is required to file the document.
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Simply sign your name in the designated area on the document.
What is the purpose of my signature above confirms?
The purpose of my signature above confirms is to indicate consent and agreement with the document contents.
What information must be reported on my signature above confirms?
Your signature confirms that you have reviewed and agreed to the information contained in the document.
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