Common Contracts

1 similar Exchange of Information Agreement contracts

Agreement for Exchange of Information
Exchange of Information Agreement • August 20th, 2018

We provide healthcare as a team of parents, doctors, nurses, dentists and educators. We also want to protect student and family confidentiality to comply with the Privacy Act of 1974. If you sign this form, you give permission for the individuals/agencies below to discuss your child's needs and share physical and mental health information. If you have any questions or comments, please call the Clinic Coordinator at (319)631-3204.

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