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I further authorize AFC AASC and AARL to release any information about my medical care to my insurance company. Signature Nathaniel Zoneraich MD FACOG Frederick Larsen MD FACOG Nicole Kummer MD FACOG Reproductive Endocrinology Infertility HIPAA PATIENT PRIVACY NOTICE Effective Date December 19 2005 Revised April 15 2016 The HIPAA Privacy Rule gives an individual a right to adequate notice of the uses and disclosures of protected health information PHI that may be made by this office and of...

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