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An Entity of Type : prov:Entity, within Data Space : webisadb.webdatacommons.org associated with source dataset(s)

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  • With this form (or a photostatic copy of it) I authorize the release of any medical or other information acquired in the course of my treatment to my insurance carrier, practitioners involved in my care at Valley Medical Center, PLLC and their agencies and to outside providers of my care.
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