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Get Enrollment Cover Sheet 2015-2024

Loyee Health Clinical Services who we have retained as a third-party to maintain the confidentiality of your health information. The University of Houston Animal Care Operations (ACO) department will not retrieve nor submit these forms in person or electronically on your behalf. Please fax the completed enrollment form to 713-486-0983. Any questions regarding this form should be directed to UT Employee Health at 713-500-3261. uh.edu/research: OHP Enrollment Cover Sheet Form updated March 2015.

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