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Alaskapts. com My signature below acknowledges that I have reviewed Alaska Physical Therapy Specialists a copy of NOTICE OF PRIVACY PRACTICES HIPPA Compliance. I PATIENT / RESPONSIBLE PARTY SIGNATURE 3650 Lake Otis Pkwy Suite 201 Anchorage Alaska 99508 Ph 907-561-4280 Fax 907-561-4282 DATE www. Alaskapts. com Page 1 of 4 CONSENT FOR CARE AND TREATMENT I give my consent to Alaska Physical Therapy Specialists to evaluate my condition and furnish physical therapy treatment as considered...
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