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Host Chiropractic Center 1354 US Route 202, Winthrop, ME (207) 3772151 PATIENT CONSENT FOR USE AND/OR DISCLOSURE OF PROTECTED HEALTH INFORMATION TO CARRY OUT TREATMENT, PAYMENT AND HEALTHCARE OPERATIONS
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Hoyt Chiropractic Center is a chiropractic clinic that offers services for spinal health and wellness.
Anyone seeking services or treatment at the Hoyt Chiropractic Center may be required to provide personal and insurance information.
To fill out the necessary information at Hoyt Chiropractic Center, patients may need to provide their personal details, insurance information, medical history, and reason for visit.
The purpose of Hoyt Chiropractic Center is to provide chiropractic care and promote spinal health and wellness.
Information such as personal details, insurance information, medical history, and reason for visit may need to be reported on Hoyt Chiropractic Center forms.
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