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This constitutes permission to release medical information regarding sexually transmitted disease if applicable to Third Party Payor pursuant to KRS 214. HIV/AIDS Alcohol/Drug Addiction Alzhemier s Arthritis Bleeding Disorders Cancer COPD/Emphysema/Bronchitis Epilepsy/Seizures Heart Attack/Stroke High Blood Pressure High Cholesterol Kidney Disease Liver Disease/Hepatitis Mental Illness Osteoporosis Sickle Cell Thyroid Disorder Tuberculosis/TB Other Immunization Status Is your child up to date...
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Form Wellness Center Maupin is a form used to report information about wellness programs offered by a center.
Any wellness center that offers wellness programs is required to file form wellness center maupin.
Form wellness center maupin can be filled out online or by mail, following the instructions provided on the form.
The purpose of form wellness center maupin is to gather information about the wellness programs offered by a center.
Information such as the types of wellness programs offered, number of participants, and outcomes of the programs must be reported on form wellness center maupin.
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