| Property | Value |
| Name | Demographic Form |
| Description | The Health Insurance Portability and Accountability Act of 1996 (HIPPA) includes provisions that require we have the following information, or your health insurance claims will not be paid. Any claims not paid by insurance are patient responsibility. |
| Filename | Corpus Demographic Page.pdf |
| Filesize | Empty |
| Filetype | pdf (Mime Type: application/pdf) |
| Creator | admin |
| Created On: | 09/13/2011 08:03 |
| Viewers | Everybody |
| Maintained by | Editor |
| Hits | 0 Hits |
| Last updated on | 09/13/2011 08:09 |
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