WELLINGTON CENTER FOR LASER DENTISI`RY have been given
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WELLINGTON CENTER FOR LASER DENTISI'RY PRIVACY NOTIC E ACKNOWLEDGEM ENT WELLINGTON CENTER FOR LASER DENTISTRY is committed to protecting the privacy of your personal healthcare inforrnation. We take this very seriously, and as such you may expect to receive newsletters and emails from us highlighting our privacy policy. More importantly, our privacy notice is written and available for you to read and take with you. Kindly acknowledge that you have been given and read, or offered a copy of our privacy notice. t, , on behalf of SELF or hereby acknowledge that I have been given a copy of the office privacy notice and read it, or have been given the opportunity to receive such a privacy notice. Signature Datr= Printed Name confirmo que he recibido una copia del informe sobre la privacidad de mi informacion o que me han ofrecido una copia de dicho informe. Esto aplica a mi informacion y a la de Yo, Firma Nombre completo Fecha
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