I understand that I have the right to revoke this authorization, in writing, at any time, except (1) when uses or disclosures have already been made based upon my original permission or (2) the authorization was obtained as a condition or securing insurance coverage, and the insurer by law has the right to contest a claim or insurance policy. I understand that uses and disclosures already made based upon my original permission cannot be taken back. To revoke this authorization, I must do so in writing, and without my expressed revocation, this consent will automatically expire 90 days from today’s date. I understand that the information used or disclosed with my permission may be re-disclosed by the recipient and no longer protected by the federal Privacy Standards. A fax company or photocopy of this consent shall be as valid as the original.