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The undersigned well-being work provider hereby authorizes Lab corporation and its subsidiaries to send patient of protected upbeat information (PHI) as defined by HIPAA (Health Insurance movableness and Accountability Act of 1996) to the fax act listed below. Additionally, the undersigned health care benefactor understands that it has deemed such transmission is needed for the purposes of welfare care treatment, payment, and/or eudaimonia concern operations. The undersigned health care bourgeois may repeal this authorisation or change the fax number, provided that the undersigned eudaimonia caution provider gives Lab Corp sensible backhand notice.
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