North Florida Regional Medical Center

North Florida Regional Medical Center Fax: 855-668-0697 Phone: 888-616-5721 Section A: This section must be completed for all Authorizations - *Required ... psychiatric, HIV testing, HIV results or AIDS information. _____ (Initial) I understand that: 1. I may refuse to sign this authorization and that it is strictly voluntary. 2. My treatment ... ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download