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NorthwestObstetrics&GynecologyAssociates, Inc PatientAcknowledgementForm NoticeofPrivacyPractices PatientName Date IhavereceivedacopyofNorthwestObstetrics&GynecologyAssociates, Incs(NOB) NoticeofPrivacyPractices.
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It appears to be a document or form related to receiving a copy of medical information or records from Northwest Obstetrics & Gynecology Associates, Inc.
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Typically, the patient or their authorized representative is required to file this document to acknowledge receipt of their medical information.
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The purpose is to confirm that the patient has received a copy of their medical records or relevant documentation from the healthcare provider.
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The document typically requires personal identification information, details of the records received, date of receipt, and signature of the patient or authorized representative.
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