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Get Patient Communication Consent Form - Dr. Benjamin Cohen

PATIENTCOMMUNICATIONCONSENTFORM IagreetoallowDr.Cohenandhisstafftocontactmeusingthefollowingmethodsregardingmypersonalhealth information,evaluationandtreatment.Iauthorize/donotauthorizeDr.Cohenandhisstafftoleavemessagesfor mewhenIamunavailableasindicatedbelow.

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