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Lifespan Medical Associates 250 West Kensington Road Mount Prospect, IL 60056 Phone: 8472229595 Fax: 8472229565Authorization for Release of Patient Health Information I hereby authorize that the protected
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Collect all necessary patient information including personal details, medical history, and insurance information.
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Individuals seeking routine healthcare services and preventive care.
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Aspiring medical professionals looking for clinical practice and training opportunities.
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Primary care clinics are healthcare facilities that provide first point of contact for patients with an undiagnosed health concern.
Primary care clinics must be filed by healthcare providers and facilities that offer primary care services.
To fill out primary care clinics, healthcare providers need to submit information about their services, patients, and outcomes.
The purpose of primary care clinics is to ensure that patients have access to timely and comprehensive healthcare services.
Information such as patient demographics, services provided, and outcomes of care must be reported on primary care clinics.
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