PATIENT ACKNOWLEDGEMENT AND CONSENT TO ONLINE INTERACTION POLICIES I wish to use Internet-based communications, registration and other Internet-based modes of interaction to facilitate my receipt of health care from this practice. Benefits and Risks:
Confidentiality and Security of Information:
1060 E Foothill Blvd SUITE 103 Upland, CA 91786-4070 Phone: (909) 981-8904 Fax: (909) 981-8943
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