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As central Georgia prepares to respond to novel coronavirus COVIDNavicent Health is taking measures to protect patients, visitors and our community. All support groups and education classes for the remainder of March will be cancelled, effective Friday, March 13, I give permission for Navicent to use the information I supply on this form to fulfill my request for a physician appointment and to contact me for that purpose.

I certify that I am at least 18 years old and I acknowledge Boy in Gary language I have read and accept these terms and agree to use this form to request a physician appointment. Because we value your privacy, your personal information will not be used other than to schedule an appointment. Navicent Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, religion, Macon evening mail personal services origin, age, disability, sex, gender identity, sexual orientation, pregnancy, Adult warehouse Rockford Iowa genetic information.

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