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By clicking SUBMIT below:  You voluntarily consent to any and all health care treatment and diagnostic procedures provided by Premier Assist and its associated clinicians.  Please be aware that the practice of medicine and other health care professionals is not an exact science and further understand that no guarantee has been or can be made as to the result of the treatments or exams at Premier Assist.  You consent to the use and disclosure of the patient’s protected health information for purposes of obtaining payment for services rendered to the patient, treatment, and health care operations consistent with the Premier Assist Notice of Privacy Practices.  You give permission to obtain all medication/prescription history when using an electronic system to process prescriptions for my medical treatment.

Thank you! We’ll be in touch.

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