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I allow [practice name] to file for insurance benefits to pay. Web most often, a consent form is used for medical purposes to hold the hospital or surgeon harmless of any wrongdoing due to the risks involved with. Web epic behavioral healthcare consent for treatment, orientation & rules and agreement for persons served epic main campus (north) 1400 old dixie highway,. Web by my signature below, i voluntarily request and consent to behavioral health assessment, care, treatment, or services and authorize my provider to provide such. Web a medical consent form serves to obtain informed consent from a patient or their legal guardian for a specific medical procedure or treatment.