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The data you submit on this kind can be used internally for the needs of processing and responding to your request. It might be routed internally with a view to discover probably the most acceptable member of employees to deal with your request and your contact data will solely be used to answer your inquiry for those who point out permission to take action.
As well as, the data submitted might grow to be part of the affected person’s everlasting chart or remedy file at The Emily Program upon their utilization of The Emily Program companies, and this data could also be used within the planning of remedy and care offered to the affected person. On the time the affected person makes use of The Emily Program companies, The Emily Program’s Discover of Privateness Practices and different HIPAA and data privateness and safety insurance policies will apply to the data submitted on this kind and to some other data that The Emily Program maintains in regards to the affected person and the care offered to the affected person.