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For Medical Records:
For Medical Records, please send your signed Authorization To Disclose Protected Health Information Form (page 4 of New Patient Forms Tab) to the address below: NOTE: Please only use this form if you were a previous patient at Integrative Child & Adolescent Psychiatry in Troy, MI. Dr. Anastasia Banicki-Hoffman 156 N. 4th Street Rogers City, MI 49779 |
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