Associated Signs/Symptoms/ Signos/Síntomas Asociados:
Por la presente asigno todos los beneficios médicos y/quirúrgicos a los que tengo derecho, incluyendo Medicare, seguro privado y otros planes a Austin Vascular & Vein Specialists. Entiendo que soy responsable de todos los cargos, obtengo el reembolso, autorizo la divulgación de partes del historial médico del paciente. ................
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