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I give permission for such diagnostic, therapeutic or emergency operative procedure as may be necessary to evaluate and treat -
I agree to waive my HIPAA (Health Insurance Portability and Accountability Act of 1996) rights, Israel’s patient privacy laws and all other applicable privacy provisions under the law, in order to allow the Harel Insurance Company medical providers, Egert and Cohen, CTAS medical providers to communicate with myself, each other, healthcare providers, parents, and school administrators regarding my/my childs health condition/s. This communication can be applicable via phone, email, WhatsApp, Skype, internet-based application or other forms of communication.