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Medical Record Request

Important Notice Regarding Your Medical History Submission

Please note that communications via our website are conducted through a secured third-party platform. This ensures that the information you provide in your medical history submission cannot be intercepted or accessed by unauthorized parties.

We are committed to protecting your confidential information, particularly your personal identifying details, medical history, and sensitive health information. We work diligently to ensure that your submissions through our website are secure and that your privacy is maintained throughout the process.

If you have any questions or concerns about the confidentiality of your information, please feel free to reach out.

By Continuing “Agree”, You acknowledge the reading of Disclaimer and agree with Terms and Conditions.

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Patients Disclaimer

Patient Form Important Notice

Please Note that communication via our website are be done through a secured third-party platform. There is not a possibility that information you include in your submission can be intercepted and read by parties other than the intended recipient. We work hard to ensure we are able to protect your confidential information, especially your personal identifying information such as your birth date or personal medical information through our website form submissions you send to us.

By Continuing “Agree”, You acknowledge the reading of Disclaimer and agree with Terms and Conditions.