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IF INSURED IS DIFFERENT THAN THE PATIENT: SS

WebISLAND NEUROLOGICAL ASSOCIATES, P.C. Patient Information: Insurance Information: _____ Name

Actived: 3 days ago

URL: http://islandneuro.com/sitebuildercontent/sitebuilderfiles/patient_registration.pdf

RECORD RELEASE AUTHORIZATION.071307

Websign this form and that my health care and payment will not be affected. The facility, its employees, officers and physicians are hereby released from any legal responsibility or …

Category:  Health Go Health

NOTICY OF PRIVACY PRACTICES ISLAND NEUROLOGICAL …

Webhealth information when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. 7. Military. Our practice …

Category:  Health Go Health

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