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Acknowledgement of Receipt of Notice of Privacy PracticesPractice Name: Repower Medical Clinic, LLC Contact Person: Does Wooden, Noncontact Phone, Email and Fax: 4805882233 (o), 4805882235 (f)info@drworden.comNotice to Patient:We are required to provide you with a copy of our Notice of Privacy Practices, which states how we Cayuse and/or disclose your health information.
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Contact Phone Email and Fax 480-588-2233 or 480-588-2235 is likely a placeholder for a contact point related to a specific form or filing requirement, often used in administrative or financial contexts.
Individuals or entities subject to the regulations or requirements associated with the specific form or filing referenced are typically required to file.
Filling out the form generally involves providing required information accurately, including personal details, financial data, and any necessary signatures, following the guidelines set forth by the relevant authority.
The purpose of the filing is likely to comply with regulatory requirements, report specific information, or facilitate communication between parties involved in the matter.
The information that must be reported typically includes identification details, financial data relevant to the filing, and any other information mandated by the regulatory authority.
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