I understand that this authorization is voluntary. I understand that my treatment, payment for it, and/or eligibility for enrollment or benefits cannot be conditioned on my signing this form. I understand that the information requested for release is specific to the above information only. I understand that I may receive a copy of this form, and I may inspect my protected health information without signing this form. I understand that my medical records may contain reports, results, and notes that only a physician can interpret. I understand and have been advised that I should contact my physician regarding entries made in my medical record to prevent my misunderstanding of the information covered in these entries. I will not hold any employee of Current Dermatology and Cosmetic Center liable for any misunderstanding of the information in my medical record as a result of not consulting with my physician for the correct interpretation. I understand that I may revoke this consent (in writing) at any time to the extent that action has already been taken. I understand that once information covered by this authorization has been disclosed, redisclosure of the information by that recipient is possible and the information may no longer be protected by the federal regulation referenced above, but may be protected by Maryland law.