dr. quinlan may use my health care information and may disclose such information to the above named...

8

Upload: others

Post on 18-Mar-2020

1 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Dr. Quinlan may use my health care information and may disclose such information to the above named insurance company(ies) and their for the purpose of obtaining payment for services
Page 2: Dr. Quinlan may use my health care information and may disclose such information to the above named insurance company(ies) and their for the purpose of obtaining payment for services
Page 3: Dr. Quinlan may use my health care information and may disclose such information to the above named insurance company(ies) and their for the purpose of obtaining payment for services
Page 4: Dr. Quinlan may use my health care information and may disclose such information to the above named insurance company(ies) and their for the purpose of obtaining payment for services
Page 5: Dr. Quinlan may use my health care information and may disclose such information to the above named insurance company(ies) and their for the purpose of obtaining payment for services
Page 6: Dr. Quinlan may use my health care information and may disclose such information to the above named insurance company(ies) and their for the purpose of obtaining payment for services
Page 7: Dr. Quinlan may use my health care information and may disclose such information to the above named insurance company(ies) and their for the purpose of obtaining payment for services
Page 8: Dr. Quinlan may use my health care information and may disclose such information to the above named insurance company(ies) and their for the purpose of obtaining payment for services