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Authorization to Release or Disclose PHI FROM CenterWell ACE (English)
Authorization to Release or Disclose PHI FROM CenterWell ACE (Spanish)
Authorization to Release or Disclose PHI FROM CenterWell ACE (Creole)
Authorization to Release or Disclose PHI TO CenterWell ACE (English)
Authorization to Release or Disclose PHI TO CenterWell ACE (Spanish)
Authorization to Release or Disclose PHI TO CenterWell ACE (Creole)
Authorization to Disclose and Retrieve Information To/From HIE (English)
Authorization to Disclose and Retrieve Information To/From HIE (Spanish)
Authorization to Disclose and Retrieve Information To/From HIE (Creole)
General Consent Form (English)
General Consent Form (Spanish)
General Consent Form (Creole)
Telehealth Services Information (English)
Provider History Form (English)
Center Privacy Notice (English)
Center Privacy Notice (Spanish)
Center Privacy Notice (Creole)
Patient Demographic Form (English)