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Notice of Privacy PracticesForm 7.20This notice describes how medical information about you may be used and disclosed, and how you can gain access
to this information. Please review it carefully.
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Sign the notice as required and submit it through the designated method mentioned in the notice.
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01
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02
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03
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04
Anyone who is responsible for ensuring compliance with the instructions or requirements mentioned in the notice.
05
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06
Any person or organization seeking to address an issue or respond appropriately as indicated in the notice.
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This notice describes how to comply with a specific reporting requirement.
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