img009 - jameskimdentistry.com · notice of privacy practices acknowledgement james kim, dds 12129...

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Page 1: img009 - jameskimdentistry.com · NOTICE OF PRIVACY PRACTICES ACKNOWLEDGEMENT JAMES KIM, DDS 12129 N FM 620, SUITE 300 AUSTIN, TEXAS 78750 (512)249-9147 I understand that, under the
Page 2: img009 - jameskimdentistry.com · NOTICE OF PRIVACY PRACTICES ACKNOWLEDGEMENT JAMES KIM, DDS 12129 N FM 620, SUITE 300 AUSTIN, TEXAS 78750 (512)249-9147 I understand that, under the
Page 3: img009 - jameskimdentistry.com · NOTICE OF PRIVACY PRACTICES ACKNOWLEDGEMENT JAMES KIM, DDS 12129 N FM 620, SUITE 300 AUSTIN, TEXAS 78750 (512)249-9147 I understand that, under the
Page 4: img009 - jameskimdentistry.com · NOTICE OF PRIVACY PRACTICES ACKNOWLEDGEMENT JAMES KIM, DDS 12129 N FM 620, SUITE 300 AUSTIN, TEXAS 78750 (512)249-9147 I understand that, under the
Page 5: img009 - jameskimdentistry.com · NOTICE OF PRIVACY PRACTICES ACKNOWLEDGEMENT JAMES KIM, DDS 12129 N FM 620, SUITE 300 AUSTIN, TEXAS 78750 (512)249-9147 I understand that, under the
Page 6: img009 - jameskimdentistry.com · NOTICE OF PRIVACY PRACTICES ACKNOWLEDGEMENT JAMES KIM, DDS 12129 N FM 620, SUITE 300 AUSTIN, TEXAS 78750 (512)249-9147 I understand that, under the