The above-named dentist may use my health care information and may disclose such information to the above-named Insurance Company(s) andtheir agents for the purpose of obtaining payment for services and determining insurance benefits or the benefits payable for related services. Signature of Patient, Parent, Guardian or Personal Representative More @Wikipedia
Hover over any link to get a description of the article. Please note that search keywords are sometimes hidden within the full article and don't appear in the description or title.