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AUTHORIZATION TO USE/DISCLOSE PROTECTED HEALTH INFORMATION I authorize: Choice O&P (a division of Choice Medical, Inc., 314 Erin Drive, Knoxville TN 37919) AND/OR: (NAME OF PERSON/ENTITY DISCLOSING
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Choice OAMPP release of is a form used to release certain claims and liabilities.
Any individual or entity involved in a legal matter where a release of claims is necessary.
Choice OAMPP release of can be filled out by providing all required information accurately and signing the form.
The purpose of choice OAMPP release of is to release claims and liabilities between parties in a legal matter.
Choice OAMPP release of must include details of the parties involved, the claims being released, and any agreed-upon terms.
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