+ All Categories
Home > Documents > ...Alex M. Pentino, DDS 107 Plaza Drive Suite F St. Clairsville, OH 43950 ACKNOWLEDGEMENT OF RECEIPT...

...Alex M. Pentino, DDS 107 Plaza Drive Suite F St. Clairsville, OH 43950 ACKNOWLEDGEMENT OF RECEIPT...

Date post: 09-May-2020
Category:
Upload: others
View: 0 times
Download: 0 times
Share this document with a friend
4
Transcript
Page 1: ...Alex M. Pentino, DDS 107 Plaza Drive Suite F St. Clairsville, OH 43950 ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES * You May Refuse to Sign This Acknowedgement* have
Page 2: ...Alex M. Pentino, DDS 107 Plaza Drive Suite F St. Clairsville, OH 43950 ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES * You May Refuse to Sign This Acknowedgement* have
Page 3: ...Alex M. Pentino, DDS 107 Plaza Drive Suite F St. Clairsville, OH 43950 ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES * You May Refuse to Sign This Acknowedgement* have
Page 4: ...Alex M. Pentino, DDS 107 Plaza Drive Suite F St. Clairsville, OH 43950 ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES * You May Refuse to Sign This Acknowedgement* have

Recommended