lacamas dental and cosmetic center · restriction: you have the right to request that we place...

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Page 1: Lacamas Dental and Cosmetic Center · Restriction: You have the right to request that we place additional restrictions on our use or disclosure of your health information. We are
Page 2: Lacamas Dental and Cosmetic Center · Restriction: You have the right to request that we place additional restrictions on our use or disclosure of your health information. We are
Page 3: Lacamas Dental and Cosmetic Center · Restriction: You have the right to request that we place additional restrictions on our use or disclosure of your health information. We are