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  • Consent to Change Personal Health Information Preference Consents Previously Signed.

  • The use of this form allows you to opt out of the following previously consented to.

  • To Submit Your Updated Preference

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    If patient is a minor.
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  • For Healow/Patient Portal, Text Messages, and marketing surveys, please follow the instructions listed to opt out of receiving notifications through those direct platforms. If you have any questions please contact DOCS Medical Inc. Administration Directors at 203-874-3682 or by e-mailing contact@DOCSofct.com

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