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By clicking next, you hereby assign and convey directly to GENETWORx as your designated authorized representative, all medical benefits and/or insurance reimbursement, if any, otherwise payable to you for services, treatments, therapies, and/or medications rendered or provided by GENETWORx, regardless of its managed care network participation status. You authorize your insurance carrier(s) to remit payment of benefits for any claim for services provided by GENETWORx directly to GENETWORx .
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