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Com. Right to Revoke You will have the right to revoke this Consent at any time by giving us a written notice of your revocation submitted to the Contact Person listed above. Please understand that revocation of this Consent will not affect any action we took in reliance of this Consent before we received your revocation and that we may decline to treat you or to continue treating you if you revoke this Consent. EXCEL EYE CARE OF TEXAS CONSENT FOR USE AND DISCLOSURE OF HEALTH INFORMATION...
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Open Microsoft Excel on your computer.
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Excel Eye Care is a comprehensive eye care clinic offering services such as eye exams, glasses, contact lenses, and treatment for various eye conditions.
Excel Eye Care must be filed by all individuals or entities that provide eye care services.
To fill out Excel Eye Care, you need to provide detailed information about the services provided, financial information, and any other relevant details.
The purpose of Excel Eye Care is to track and report on the provision of eye care services in a comprehensive manner.
Information such as services provided, financial data, patient demographics, and any other relevant details must be reported on Excel Eye Care.
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