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I have read and understood the Terms and Conditions, including the reasons for the collection and use of my personal information. I understand my choices regarding the information I provide, my right to access and correct my information, and the circumstances under which access might be denied. I acknowledge that I have been given an opportunity to obtain a copy of the practice’s Privacy Policy. By ticking this box, I agree to the use and disclosure of my personal information as described.

Terms and Conditions Agreement
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