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Authorization for Alternate ConsentAuthorization for Alternate Consent
Authorization for Alternate Consent Sale price$150.00
(5.0)
Confidential Teen Questionnaire 15-18yrConfidential Teen Questionnaire 15-18yr
Confidential Teen Questionnaire 15-18yr Sale price$150.00
Downtime Form - AdultDowntime Form - Adult
Downtime Form - Adult Sale price$150.00
Downtime Form - PediatricDowntime Form - Pediatric
Downtime Form - Pediatric Sale price$150.00
General Health Questionnaire - AdultGeneral Health Questionnaire - Adult
General Health Questionnaire - Adult Sale price$150.00
Informed Consent for In-Office ProceduresInformed Consent for In-Office Procedures
Informed Consent for In-Office Procedures Sale price$150.00
New Patient Registration & Financial Responsibility FormNew Patient Registration & Financial Responsibility Form
New Patient Registration & Financial Responsibility Form Sale price$150.00
New Patient Registration FormNew Patient Registration Form
New Patient Registration Form Sale price$150.00
OBGYN QuestionnaireOBGYN Questionnaire
OBGYN Questionnaire Sale price$150.00
Patient Financial Responsibility FormPatient Financial Responsibility Form
Patient Financial Responsibility Form Sale price$150.00
Pediatric Health QuestionnairePediatric Health Questionnaire
Pediatric Health Questionnaire Sale price$150.00
Privacy Notice PracticesPrivacy Notice Practices
Privacy Notice Practices Sale price$150.00
Release of InformationRelease of Information
Release of Information Sale price$150.00