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English PATIENT FORMS

Spanish PATIENT FORMS

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For Life-Threatening Emergencies Call 911
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Please note that no one will be denied access to services due to inability to pay.
There is a discount/sliding fee schedule available. Please contact our office for more information. 

No mobile information will be shared with third parties/affiliates for marketing/promotional purposes. All the above categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties.

**NOTE** "All the above categories" refers to the previous list in the statement third parties/affiliates for marketing/promotional purposes.

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© 2020 by Hometown Pediatrics

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