BOARD CERTIFIED
PATIENT ACKNOWLEDGEMENT AND CONSENT TO ONLINE INTERACTION POLICIES I wish to use Internet-based communications, registration and other Internet-based modes of interaction to facilitate my receipt of health care from this practice. Benefits and Risks:
Confidentiality and Security of Information:
309 NORTHBOUND GRATIOT MT CLEMENS, MI 48043-5748 Phone: (586) 463-5831 Fax: (586) 221-4395
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