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Birth preferences reviewed by doctor or midwife:_______________________________________ date ______________ we do not discriminate on the basis of race, color, national origin, sex, age or disability in their health programs and activities Charity care/financial assistance application form instructions this is an application for financial assistance (also known as charity care) at swedish. Today, providence swedish represents the largest, most comprehensive health care delivery system in the puget sound with eight hospital campuses, including our five swedish hospital campuses. Hospital medical record requests only to Swedish medical center release of information department 747 broadway, seattle, wa 98122 email
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