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Forms

Forms

HIPPA Privacy Notice Acknowledge

No Surprise Billing Waiver/Consent

EEG Questionnaire

UHC Designation of Authorized Representative

Forms - Spanish

Reconocimiento Del Aviso de Privacidad de Hippa

Renuncia/consentimiento de facturación sin sorpresas

EEG Cuestionario

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At Comfort Neuro, we bring hospital-grade neurological and sleep diagnostic services to the comfort of your home.

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  • 12409 W Indian School Road
  • info@comfortcareneuro.com
  • +1 (623) 322-0330
  • 09.00 AM - 05.00 PM

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