Common Contracts
1 similar Use and Disclose Your Health Information contracts
CONSENT TO USE AND DISCLOSE YOUR HEALTH INFORMATIONUse and Disclose Your Health Information • September 25th, 2019
This form is an agreement between you, and Matthew J. Mauriello, MA, P.C. (DBA “The Mauriello Group”). When we use the words “you” and “your” below, this can mean you, your child, a relative, or some other person if you have written his or her name below as the identified client.
