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FAX TO 3166834360AUTHORIZATION TO DISCLOSE HEALTH INFORMATION To be completed by the patient to authorize disclosure to self or others Patient Name Social Security/Account Number Address and Phone
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Fax to 316-683-4360 is a method of transmitting documents via a fax machine to the specified recipient.
Individuals or organizations who need to send documents to the recipient at 316-683-4360 are required to file a fax to that number.
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