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1 Page Confidential Intake Form Please allow our staff to photocopy your driver s license and insurance details. All information you supply is confidential. We comply will all federal privacy standards.
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We comply will all refers to adhering to all rules, regulations, and standards.
All individuals or organizations who are subject to the rules and regulations specified.
You must provide accurate and complete information as required by the governing body.
The purpose is to ensure compliance with all relevant laws and regulations.
All relevant information relating to the specific rules and regulations.
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