Get the free I have received and read a copy of Dr Deidra Kokel Notice of Privacy Practices
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This consent form will not allow Deidra B Kokel DDS PC to release any other information to these family members. You have the right to revoke this consent in writing except where we have already made disclosures in reliance on your prior consent. ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES I have received and read a copy of Dr Deidra Kokel Notice of Privacy Practices. NameRelationship to Patient Date From time to time it is necessary for representatives of Deidra B Kokel DDS PC...
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What is i have received and?
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