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Pfeiffer Medical Center 3S721 West Street, Ste 300 Greenville, IL 60555 (630) 5050300 Fax (630) 8360667 Authorization for Release of Information/Medical Record Patient Name Date of Birth I, the undersigned,
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Note: It is important to consult with healthcare professionals or contact the Pfeiffer Treatment Center directly for specific information regarding their applications, enrollment process, and whether or not their services are appropriate for your particular situation.
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The Pfeiffer Treatment Center is a medical facility specializing in nutritional therapies for mental health disorders.
Individuals seeking treatment at the Pfeiffer Treatment Center or their legal guardians are required to file relevant documents and forms.
To fill out the Pfeiffer Treatment Center forms, individuals need to provide detailed information about their medical history, current symptoms, and any treatments they have undergone.
The purpose of the Pfeiffer Treatment Center is to provide personalized nutritional therapies to address mental health disorders and symptoms.
Information such as medical history, current symptoms, previous treatments, and dietary habits must be reported on the Pfeiffer Treatment Center forms.
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