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SOUTH LINCOLN PSYCHIATRY, LLC 2001 Pine Lake Rd, Suite 300 Lincoln, NE 68512 Office: (402) 4477221 Fax: (402) 4477222TELEHEALTH PATIENT CONSENT FORM I, herebygivemyconsenttoNancyGerrard, APRN, LLC,
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South Lincoln Psychiatry LLC is a limited liability company that offers psychiatric services in the South Lincoln area.
The owners or managers of South Lincoln Psychiatry LLC are required to file the necessary paperwork with the appropriate government agencies.
To fill out the paperwork for South Lincoln Psychiatry LLC, the owners or managers must provide information about the business structure, ownership, location, and services provided.
The purpose of South Lincoln Psychiatry LLC is to provide high-quality psychiatric services to individuals in the South Lincoln area.
Information that must be reported for South Lincoln Psychiatry LLC includes business name, address, ownership structure, services offered, and any other relevant details.
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