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UNIFORM PEDIATRICS, PA
PATIENT CONSENT FOR USE AND DISCLOSURE
OF PROTECTED HEALTH INFORMATIONWith my consent, Unifour Pediatrics, PA may use and disclose protected health
information (PHI) about my
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Unifour Pediatrics PA is a medical practice that specializes in pediatrics.
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To fill out Unifour Pediatrics PA paperwork, you must provide accurate information about the practice.
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The information reported on Unifour Pediatrics PA paperwork may include financial data, patient records, and operational details.
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