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1359 Old Water Works Rd SW
Fort Payne, AL 35968-3347
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PATIENT REGISTRATION
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Medical History Front
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Medical History Back
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Medical Records Release
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HIPAA & CONSENT
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ACKNOWLEDGEMENT FORM
english Patient Registration
Spanish patient registration
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PATIENT REGISTRATION
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Medical History Front
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Medical History Back
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Medical Record Release
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HIPAA & CONSENT
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ACKNOWLEDGEMENT FORM
Miscellaneous
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