%PDF-1.4
%
1 0 obj
<>stream
FREE PDFill PDF and Image Writer
PScript5.dll Version 5.2.22013-08-27T14:15:39-04:00
Microsoft Word - Auth for Release of Medical Records rev 082713WAITING ROOM
endstream
endobj
2 0 obj
<>
endobj
4 0 obj
<>
endobj
3 0 obj
<>
endobj
5 0 obj
<>/MediaBox[0 0 612 792]/Rotate 0>>
endobj
7 0 obj
<>stream
x]Y-qdɶ
+2^5#y/[ <+Ov HyOɪ>MV̢{FL5XZVzO>m\ʝt!>tItN9'RU:x}zWnəΟ
=⟍ 'kVZ7Njw}_u&㵥kKTXFFH+#ۖq)jGpݫwcr+w
ނܼv{gNhco^K2[*ov{f{r[xt99y
pMT'"Y7oM|~>Mo-u:=6e7n9]֛"&{͆W}M>EЫwn-yyNZ -B)4icuNʨMYQSñx
zKI[mV%nʟ
euhQr_sra]UTAO7Mp6&@ :˚d6aeyN+.^J3/~-cnbeBUxcQՑ{9^Z0C7
OE~;KI97ZcurQk^Aٓ^&2D0sg"
}
ȡ-c)hGlkzZ7?_!BI]
*}*5%hpNG 6TZI#"
@Q6߾ņ&Kӧ;W /s:\kSow1h~ۥbkV_ʏ?=kx4D?g}#Wa+'! ~30֘o^_MucxF51\'L ?m̅wq5/ϐߺ="ҡuI{~
Y8ο^A}
'KxA)yU6:M@|(xQ9H}e027}dE e<o`/``v!"ҮtQF?!]0vZ}vr#%dq;`?91N1noo!eTtYcxڔ`)Lv##Q2?'~ѧ!dKp̦Aޡe_`I
%)
p7\ubߺ30{z`*D:*6*읻j$n\%9Wz:+,eHA)fIz#0NsԷb