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Adult Proxy Form Access to Another Adults Chart Record To request proxy access to the Chart record of an adult patient, please complete this form. The patient or their legal representative must sign

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What is to request proxy access?

Proxy access allows a shareholder to delegate his or her voting rights to another person or entity.

Who is required to file to request proxy access?

Shareholders who are unable to attend a company's shareholder meeting may file to request proxy access.

How to fill out to request proxy access?

To request proxy access, shareholders must complete the necessary form provided by the company and submit it before the deadline.

What is the purpose of to request proxy access?

The purpose of requesting proxy access is to ensure that a shareholder's voting rights are exercised in their absence.

What information must be reported on to request proxy access?

Shareholders must report their name, number of shares held, and the individual or entity to whom they are delegating their voting rights.

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