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This form describes what we will do if you give your permission to share patient information about you for use in research.

* View Word doc Last Updated | 6-5-17 8:20 a.m.

This document is a tool to assist investigators and staff involved in presenting Protocol-Specific HIPAA authorizations to patients enrolling on Fred Hutch research protocols and is NOT intended for distribution to study participants or patients.

* View Word doc Last Updated | 6-5-17 8:20 a.m.