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Withdrawal of Consent
IH ANY/Alliance Individual Consent To Receive and Share
Health Information
I have previously signed an Individual Consent that allowed the Alliance for Better
Health Care, LLC,
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Start by opening the withdrawal of consent form.
03
Enter your personal information such as your full name, address, and contact details.
04
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05
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06
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Who needs withdrawal of consent ihanyalliance?
01
Anyone who has previously given consent to ihanyalliance and now wishes to revoke it needs withdrawal of consent ihanyalliance.
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