Complete and sign these forms before your first visit. For documents in another language, please contact us.
English
Document
Consent for Treatment
(45.26 KB)
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Release of Information
(169.16 KB)
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Email Consent Form
(41.71 KB)
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Text Message Consent form
(41.74 KB)
Español (Spanish)
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አማርኛ (Amharic)
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እንዲለቀቅ የተሰጠማረጋገጫ (Release of Information)
(302.54 KB)
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የኢሜይል ፈቃደኝነት ቅጽ (Email Consent)
(202.73 KB)
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عربي (Arabic)
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الإفصاح عن المعلومات (Release of Information)
(190.47 KB)
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中文 (Simplified Chinese)
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治疗服务同意书 (Consent for Treatment)
(161.29 KB)
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信息发布授权书 (Release of Information)
(131.65 KB)
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电子邮件同意书 (Email Consent)
(507.09 KB)
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短信同意书 (Text Message Consent)
(490.21 KB)
한국인 (Korean)
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치료 서비스에 대한 동의 (Consent for Treatment)
(141.42 KB)
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정보 공개 승인 (Release of Information)
(6.69 MB)
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이메일 동의 (Email Consent)
(185.13 KB)
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문자메시지 수신 동의 (Text Message Consent)
(181.51 KB)
Pусский (Russian)
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Soomaali (Somali)
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Ogolaanshaha Email-ka (Email Consent)
(185.13 KB)
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Tiếng Việt (Vietnamese)
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Đồng ý nhận qua Email (Email Consent)
(217.24 KB)
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