Alabama Orthopedic, Spine & Sports Medicine Associates

205-838-3900

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*Are you seeking a second surgical opinion?	Yes No
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*	I understand that AOSSMA cannot guarantee privacy for e-mail communications over the internet, other than website submissions from their official website, www.aossma.com. I understand and accept this risk, and thus, will allow AOSSMA to communicate my protected health information using my personal e-mail address listed above.