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! Patient General Consent / AcknowledgementPatient ID Number Patient Initials NOTICE OF FINANCIAL POLICIES Mission East Dallas will charge persons receiving health services at the usual and customary
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Servicesmission East Dallas is a non-profit organization that provides various services to the community in East Dallas.
Individuals or organizations who have received services or benefits from Servicesmission East Dallas may be required to file.
To fill out Servicesmission East Dallas, you can visit their website and follow the instructions provided on the forms.
The purpose of Servicesmission East Dallas is to track and report the services provided to the community and ensure accountability.
Information such as the type of service received, date of service, and personal information of the recipient may need to be reported.
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