div class=ts-pagebuttonPage 1button div class=ts-image amp-img class=ts-thumb alt=Page 1: PatientPop · any other remedies necessary in connection with same I hereby assign directly to Healthcare Provider all rights to payment benefits and all other legal rights under src=https:reader033vdocumentinreader033viewer20220505165fa07e08dc1329112c66c978html5thumbnails1jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 2button div class=ts-image amp-img class=ts-thumb alt=Page 2: PatientPop · any other remedies necessary in connection with same I hereby assign directly to Healthcare Provider all rights to payment benefits and all other legal rights under src=https:reader033vdocumentinreader033viewer20220505165fa07e08dc1329112c66c978html5thumbnails2jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 3button div class=ts-image amp-img class=ts-thumb alt=Page 3: PatientPop · any other remedies necessary in connection with same I hereby assign directly to Healthcare Provider all rights to payment benefits and all other legal rights under src=https:reader033vdocumentinreader033viewer20220505165fa07e08dc1329112c66c978html5thumbnails3jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 4button div class=ts-image amp-img class=ts-thumb alt=Page 4: PatientPop · any other remedies necessary in connection with same I hereby assign directly to Healthcare Provider all rights to payment benefits and all other legal rights under src=https:reader033vdocumentinreader033viewer20220505165fa07e08dc1329112c66c978html5thumbnails4jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 5button div class=ts-image amp-img class=ts-thumb alt=Page 5: PatientPop · any other remedies necessary in connection with same I hereby assign directly to Healthcare Provider all rights to payment benefits and all other legal rights under src=https:reader033vdocumentinreader033viewer20220505165fa07e08dc1329112c66c978html5thumbnails5jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 6button div class=ts-image amp-img class=ts-thumb alt=Page 6: PatientPop · any other remedies necessary in connection with same I hereby assign directly to Healthcare Provider all rights to payment benefits and all other legal rights under src=https:reader033vdocumentinreader033viewer20220505165fa07e08dc1329112c66c978html5thumbnails6jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 7button div class=ts-image amp-img class=ts-thumb alt=Page 7: PatientPop · any other remedies necessary in connection with same I hereby assign directly to Healthcare Provider all rights to payment benefits and all other legal rights under src=https:reader033vdocumentinreader033viewer20220505165fa07e08dc1329112c66c978html5thumbnails7jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 8button div class=ts-image amp-img class=ts-thumb alt=Page 8: PatientPop · any other remedies necessary in connection with same I hereby assign directly to Healthcare Provider all rights to payment benefits and all other legal rights under src=https:reader033vdocumentinreader033viewer20220505165fa07e08dc1329112c66c978html5thumbnails8jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 9button div class=ts-image amp-img class=ts-thumb alt=Page 9: PatientPop · any other remedies necessary in connection with same I hereby assign directly to Healthcare Provider all rights to payment benefits and all other legal rights under src=https:reader033vdocumentinreader033viewer20220505165fa07e08dc1329112c66c978html5thumbnails9jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 10button div class=ts-image amp-img class=ts-thumb alt=Page 10: PatientPop · any other remedies necessary in connection with same I hereby assign directly to Healthcare Provider all rights to payment benefits and all other legal rights under src=https:reader033vdocumentinreader033viewer20220505165fa07e08dc1329112c66c978html5thumbnails10jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 11button div class=ts-image amp-img class=ts-thumb alt=Page 11: PatientPop · any other remedies necessary in connection with same I hereby assign directly to Healthcare Provider all rights to payment benefits and all other legal rights under src=https:reader033vdocumentinreader033viewer20220505165fa07e08dc1329112c66c978html5thumbnails11jpg width=142 height=106 layout=responsive amp-img divdiv