- Location248936tel:443-481-1000Luminis Health Anne Arundel Medical Center Hospital Pavilion South 2001 Medical Parkway Annapolis, MD 21401The pediatric ER at Luminis Health Anne Arundel Medical Center is staffed 24 hours a day by board-certified pediatric specialists. Because we also have a dedicated pediatric inpatient and pediatric surgery program, our pediatric specialists are ready in any emergency. Our state-of-the-art diagnostic services mean that we can diagnose and treat children's conditions more quickly. And because emergency rooms can feel frightening for young patients, we've designed the space with kids in mind. It's comforting, bright, and fun. Child life specialists also help comfort and entertain children., Conditions we frequently see children for at the ER include:, We know this can be a stressful time. We've streamlined the process for your visit, including: Registration. When you arrive at the pediatric emergency room, you check in and provide information like your address and phone number. Triage. A triage nurse asks you questions about your child's illness or injury, checks your child's temperature and weight, and briefly examines your child. We make sure a provider sees children with life-threatening conditions right away. Our waiting area. You remain in the waiting area until a provider is available to examine your child. Please understand patients may not be seen in the same order of their arrival. Patients with the most serious illnesses and injuries will usually be given priority. The exam. We'll bring you and your child into a treatment area, where our expert team cares for your child. Depending on your child's condition, your doctor may order a blood test, x-rays or other tests that help diagnose. We explain each test to you first. Discharge. When your child's care is complete, we give you instructions about any care you may need to provide at home. Admission to the hospital. For children who need additional care, we have a pediatric inpatient unit at LH AAMC., The pediatric ER sees all patients, regardless of whether you have health insurance. If you are a self-pay patient, we can connect you to government programs that may help with your health care costs. Plus, our billing department can work with you on payment plans. Don't let your ability to pay keep you from seeking the emergency care you need. We provide medically necessary services to everyone, no matter your ability to pay. Call our Financial Counseling office at 443-481-6500 or learn more about payment options.Asthma attacks and respiratory problems, Broken bones, Burns, cuts, or other wounds, Concussions, Diabetes complications, Digestion problems, Fever for infants under 2 months old, Infections, Sports injuries, Sprains and strains, Thoughts of hurting themselves or others, Vomiting or diarrhea that won't seem to stop
- General Page - Tier 2Patient Forms Forms must be completed online or faxed to our preregistration department at (667) 204-7241 at least 72 business hours prior to your visit or your appointment(s) will be cancelled. If you need to submit medical records prior to your appointment, please send all medical records to [email protected] or fax records to 667-204-7229., New GYN Patients (New to our practice or not seen in three or more years) If you are being referred to us by another physician, please bring your referral form, if applicable, and any lab results that are relative to your visit with us. Be prepared to give us the name, address and phone number of your primary care physician., New Prenatal Patient Packet (New to our practice, have not been seen in over three years, or new pregnancy) We will need to register your care with your insurance company, so please remember to fax your forms, as well as a copy of your insurance card at least 72 business hours prior to your initial visit or your appointment(s) will be cancelled. Please make every effort to obtain a copy of your prior records before your visit. A copy of our record request form can be found at the bottom of this page. Transferring from another OB? We will need your prenatal records before we can make you an appointment for your initial visit with our practice. Please complete the New Patient OB Transfer Checklist along with the Consent to Release Medical Records to Luminis Health OB-GYN – Annapolis form , and forward those to your previous OB-GYN. Once we receive your records we can begin your pre-registration process., Records Request Form In an effort for our providers to have your complete medical history at your visit, we ask that you obtain these records from your prior physician’s office. Please download, print, and complete the form below to obtain your records from your previous healthcare provider., If you would like a copy of those records, please have records sent directly to you so you can make a copy for yourself, prior to bringing them to our office. Once we receive your records, we will not return them to you. There is a place on the form to check ‘send records to patient’. Keep in mind that some offices take up to one month to process your request for records. Records should be mailed to Luminis Health OB-GYN – Annapolis office or hand-carried to your appointment. If you would like a copy of your records from our practice, please print, complete and fax the following form., Patient Resources, Printable Forms To view the forms listed below, you will need Adobe Reader . Please download and print one set of forms only. Do not complete forms for two different appointment types. Click on the link that describes your appointment type.These forms are for the Luminis Health Ob-Gyn locations in Annapolis, Kent Island, Pasadena and Waugh Chapel. Check with your Luminis Health Ob-Gyn office or your MyChart profile to determine the forms that they may require.
- General Page - Tier 2Check in with Your Family Doctor Even if you feel healthy, you should see your primary care doctor at least once a year. By monitoring your health over time, your primary care doctor notices early signs of problems. We can help you prevent diseases, like diabetes or heart disease, before they start. If you don't have a primary care provider, you can find one here . Quit Smoking If you're thinking it's too late for you to quit, think again! According to the Centers for Disease Control, once you've stopped smoking for three to six years, your added risk of coronary heart disease drops by half. And by the time you've gone five to ten years without smoking, your added risk for many cancers also halves. You'll also have seriously reduced your risk of heart attack and stroke. Ready to add years to your life? Call Maryland's hotline, 1-800-QUIT-NOW, or check out resources at smokefree.gov . Learn how Luminis Health can help you take the first step, call 443-481-5366 . Because it's always easier to do hard things when you have friends around you! Keep up to Date on Routine Cancer Screenings Routine cancer screenings let your doctor catch cancers at an early stage when they're easiest to treat. Some screenings even catch precancers, letting you remove cells before they turn into cancers. Pretty amazing, right? At Luminis Health, we offer cervical, breast, colon and lung cancer screening, based on age and risk factors. We also offer low-cost and free screenings for those who need them. Check with your doctor about which cancer screenings you should receive. Get Outside Getting outside has benefits for your mental and physical health. Sunlight, fresh air and a stroll among the trees can boost your mood. Plus, if you're outside cycling, walking or jogging, you're also getting major heart health benefits. Boost Your Immune System with Vaccines You might hit the gym to work out your muscles, but your immune system needs training too. Vaccines help your immune system recognize and attack dangerous viruses in case you're exposed in the future. Your primary care doctor can check to see if you're up to date on your recommended vaccines. Luminis Health offers flu and COVID vaccine clinics with partner community organizations, schools, residences and faith-based groups. Check out our calendar to find out about vaccine clinics near you. Get Enough Sleep Poor sleep doesn't just make you grumpy. People who consistently don't get enough sleep have a higher risk of chronic diseases, including diabetes, obesity, heart disease and depression. To improve your sleep, aim to go to bed at the same time every night and avoid screens two hours before bed. Limiting caffeine in the afternoon, reducing alcohol and getting exercise in the day can also help you sleep more soundly. And Yes, Eat Your Veggies Improving your diet doesn't have to be complicated. It simply means upping the veggies, fruits and lean protein in your diet — all while reducing fried foods, processed foods and sweets. Once you open your horizons to new recipes and seasonings, you'll discover healthy meals are both flavorful and satisfying. Move over boring meatloaf, hello grilled salmon with mango salsa and greens! Learn more about our nutrition services . Overwhelmed? Take It One Day at a Time woman meditating on a patio outdoors Changing your daily health habits can feel daunting. But you don't have to change everything at once. Instead, focus on a change you can make today — like quitting smoking or getting outside every day. Then, you can add on other lifestyle changes when you're ready. Talk to your friends and family about your goals so they can support you. And remember, your Luminis Health providers are here to help, and we're cheering you on, too!Our Top Tips for Living a Healthy and Happy Life Your health is influenced by the dozens of decisions you make each day — day after day, week after week. Choices like cooking at home instead of ordering pizza, going for a walk on a sunny day and hitting the sack a little earlier. Ready to make your health a priority? Here are our top tips to prevent disease, increase your energy, and feel better.
- Location250526tel:443-481-58262003 Medical Parkway, Wayson Pavilion, Suite G-10 Annapolis, MD 21401Ambulatory Care Pharmacy Services (previously anticoagulation services) offer medication management services for patients in need of anticoagulation/ blood thinners and diabetes medication management. Ambulatory Care Pharmacy Services clinic, we have onsite doctors and pharmacists who work together with your doctor to keep you healthy. We provide medication refills and order necessary labs as indicated. We make sure you get the right medication at the right dose and time. We monitor you closely to prevent and treat side effects. And, if you're a Luminis Health patient, we coordinate your care by reviewing and updating your single medical record. We recognize you're more likely to have better health when you know more about your treatment and condition. We empower you with information and help you make important lifestyle changes. This lowers your risk of health problems even further. You'll also be glad to know that we're here for you with convenient hours, including early morning appointments to accommodate your work schedule. About Your Appointment The last appointment of the day is 30 minutes before the clinic closes. Dedicated, free parking spots are available for Ambulatory Care Pharmacy Services in Garage B (reserved spaces may still read Anticoagulation Clinic.) Holiday closures include New Year's Day, Martin Luther King Jr. Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, and Christmas., We provide onsite testing, medication adjustments and education for those who receive anti-coagulation and/or diabetes therapy. Education Your dedicated team teaches you all about your specific medication. We offer a 45-60 minute initial education appointment and take the time to answer any questions you have. We provide information for you to review at home and additional advice and support at your follow-up appointments. We cover: How to properly take your medicine. How diet, alcohol, stress or medications can affect your therapy. Possible side effects and how to manage them. Warning signs to watch. Our onsite educators help you to maintain your health in other ways, too. We support you by offering diet, lifestyle and exercise changes that are actually achievable. Do you have concerns about your condition? Questions about your treatment? Your caring and knowledgeable team is happy to provide the answers and reassurance you need. Onsite Rapid Testing and Medication Changes We offer point-of-care testing to check your international normalized ratio (INR) and glucose.
- General Page - Tier 2This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. Effective Date: April 14, 2003 Revised: June 1, 2022 AFFILIATED COVERED ENTITY Luminis Health, Inc. and its affiliated entities and subsidiaries are under common ownership and control and are organized as a single Affiliated Covered Entity (ACE) for the purposes of the HIPAA Privacy Rule. We will share Protected Health Information (PHI) with each other as necessary to carry out treatment, payment, or health care operations as otherwise permitted by applicable law, or as stated in this Notice. We will do so through access to a shared electronic medical record. WHO WILL FOLLOW THIS NOTICE This notice applies to Luminis Health, Inc. and all of its subsidiaries, all healthcare professionals authorized to enter information into your chart, all volunteers authorized to help you while you are here, all of our employees and on-site contractors, all departments and units within the hospital, all healthcare students, all healthcare delivery facilities and providers within the Luminis Health system, and your personal doctor and others while they are providing care at this site. Your doctor may have different policies or notices regarding your medical information created in their private office or clinic. OUR PLEDGE REGARDING MEDICAL INFORMATION Luminis Health is committed to protecting your medical information. We understand that medical information about you and your health is personal. We create a record of the care and services you receive at Luminis Health. This Notice tells you about the ways in which we may use and disclose your medical information and applies to all of the records of your care generated by Luminis Health. It also describes your rights and certain obligations we have regarding the use and disclosure of medical information. We are required by law to: Make sure your medical information is protected. Give you this notice of our legal duties and privacy practices with respect to your medical information. Follow the terms of the notice that is currently in effect. HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU The following categories describes different ways that we may use and disclose your medical information. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of these categories. Treatment. We may use medical information about you to provide you with medical treatment or services. For example, a doctor treating you for a broken hip may need to know if you have diabetes because diabetes may slow the healing process. We may also share medical information about you with other Luminis Health personnel or non-Luminis Health people Luminis Health who may be involved in your ongoing care, such as family members, clergy, or others who provide services that are part of your care, such as therapists or physicians. As part of our Collaborative Care Network, your medical information may be used to facilitate ongoing care management activities. Payment. We may use and disclose medical information about you to bill and collect payment from you, your insurance company or a third-party payor for the services you received. For example, we may need to give your health plan information about treatment you received at Luminis Health Luminis Health so your health plan will pay us or reimburse you for the treatment. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment. Healthcare Operations. We may use and disclose medical information about you for day-to-day operations. These uses and disclosures are made to enhance quality of care and for certain medical staff activities. For example, we may use medical information to evaluate our services and the performance of our staff in caring for you. Medical information about many Luminis Health patients may be combined to decide what additional services Luminis Health should offer, what services are not needed, and whether certain new treatments are effective. Information may also be disclosed to doctors, nurses, technicians, medical students, and other Luminis Health personnel for review and learning purposes. We may disclose information about you for another hospital’s health care operations if you also have received care at that hospital. We may also include your health information in registry databases to evaluate treatment and outcomes at a state and national level. We may contact you to determine how satisfied you are with our services. We may contract with vendors and outside agencies to provide care and/or to assist in collecting information to assess and improve our services. We may also disclose information to accrediting agencies which review hospital operations to ensure quality of care. Health Information Exchange. We may share information that we obtain or create about you with other health care providers or other health care entities, such as your health plan or health insurer, as permitted by law, through Health Information Exchanges (HIEs) in which we participate. For example, information about your past medical care and current medical conditions and medications can be available to us or to your non-Luminis Health primary care physician or hospital, if they participate in the HIE as well. Exchange of health information can provide faster access, better coordination of care and assist providers and public health officials in making more informed decisions. The Chesapeake Regional Information System for our Patients, Inc. (CRISP) is a regional internet based HIE in which we participate. We may share information about you through CRISP for treatment, payment, health care operations, or research purposes. You may “opt-out” and prevent searching of your information available through CRISP by calling 1-877-952-7477 or completing and submitting an Opt-Out form to CRISP by mail, fax or through their website at www.crisphealth.org. Luminis Health may also participate in other HIEs, including HIEs that allow your provider to share your information directly through our electronic medical record system. For example, if you were seen by a different provider, they may electronically view your information to see the care you were provided at Luminis Health. You may choose to opt-out of these other HIEs by contacting the Luminis Health privacy office. Photographs, Video and Audio Recordings. We may obtain photographs, video and audio recording of your healthcare treatment at Luminis Health for the purpose of healthcare treatment, teaching and operations. Such photographs, video or audio recordings will not be used for marketing purposes unless you specifically authorize such use. If you do not want photographs, video or audio records made of your healthcare treatment, you may specifically request that such photographs, video or audio records not be made by notifying your physician. Appointment reminders and service information. We may use and disclose your medical information to contact you to provide appointment reminders or to let you know about treatment alternatives or other health related services or benefits that may be of interest to you. Fundraising Activities. We may contact you in an effort to raise money for Luminis Health and its non-profit patient care programs. For this purpose, we may use your contact information, such as your name, address, phone number, the dates of service and the department from which you received treatment or services at Luminis Health, your treating physician’s name, your treatment outcome and your health insurance status. You may restrict use of your information for this purpose by contacting 888-890-6919 or by email at [email protected]. Your choice to opt out of fundraising communications in no way will affect your right to receive treatment by Luminis Health. Luminis Health Facility Directory. We may include certain limited information about you in the Luminis Health facility directory while you are an in-patient at Luminis Health. This information may include your name, location in the hospital, your general condition (e.g., fair, stable, etc.), and your religious affiliation. The directory information, except for your religious affiliation, may also be released to anyone who asks for you by name. Your religious affiliation may be given to a member of the clergy, such as a priest or rabbi, even if they don’t ask for you by name. This is so your family, friends, and clergy can visit you and generally know how you are doing. If you do not want anyone to know directory information about you, if you want to limit the amount of directory information that is disclosed, or if you want to limit who gets directory information, this type of information may be restricted from being released. Please alert the registration staff or your caregiver to request to opt out of the facility directory. Individuals Involved in Your Care or Payment for Your Care. We may release medical information about you to a friend or family member who is involved in your medical care. This includes persons named in any durable health care power of attorney or similar document provided to us. We may also give information to someone who helps pay for your care. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location. If you are not present or cannot agree or object, we will use our professional judgment to decide whether it is in your best interest to release relevant information to someone who is involved in your care or to an entity assisting in a disaster relief effort. You may request us to restrict sharing of your health status with someone who is involved in your care or for disaster relief efforts. Marketing. We may use your medical information to forward promotional gifts of nominal value, to communicate with you about a service, products and educational programs offered by Luminis Health. We do not share your medical information to any third party for their marketing activities unless you sign an authorization allowing us to do this. Research. We may use and disclose medical information about you for research purposes. All research projects must be approved by a research review board which evaluates the research proposal and establishes standards to protect the privacy of your health information. We may use or disclose your medical information to a researcher preparing to conduct a research project. Organ and Tissue Donation. If you are an organ donor, we may release medical information to organizations that handle organ procurement or organ, eye, or tissue transplantation, or to an organ donation bank as necessary to facilitate organ or tissue donation and transplantation. Workers’ Compensation. We may release medical information about you for Workers’ Compensation or similar programs. These programs provide benefits for work-related injuries or illness. Public Health activities. We may disclose medical information about you for public health activities. These activities generally include the following: To prevent or control disease, injury, or disability. To report deaths. To report reactions to medications or problems with products; to notify people of recalls of products they may be using. To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition. To notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence. We will only make this disclosure if you agree or when required or authorized by law. As Required by Law, Legal Proceedings, Health Oversight Activities and Law Enforcement. We may disclose your health information when we are required to do so by federal, state and other law. For example, we may be required to report victims of abuse, neglect or domestic violence, as well as patients with gunshot and other wounds. We will disclose your health information when ordered in a legal or administrative proceeding, such as a subpoena, discovery request, warrant, summons, or other lawful process. We may disclose health information to a law enforcement official to identify or locate suspects, fugitives, witnesses, victims of crime, or missing persons. We may disclose health information to a law enforcement official about a death we believe may be the result of criminal conduct or about criminal conduct that may have occurred at our facility. We may disclose health information to a health oversight agency for activities authorized by law, such as audits, investigations, inspections, and licensure. We may disclose your health information to the Secretary of Health and Human services for the purpose of determining compliance with and enforcement of these rules. To Avert a Serious Threat to Health or Safety. We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. However, any disclosure would only be to someone able to help prevent the threat. Coroners, Medical Examiners, and Funeral Directors. We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about deceased patients of Luminis Health to funeral directors as necessary to carry out their duties upon the request of the patient’s family. Specialized Government Functions. If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority. We may disclose health information to make medical suitability determinations for Foreign Service. We may disclose health information to authorized federal officials for national security purposes, such as protecting the President of the United States or the conduct of authorized intelligence operations. Correctional facilities. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release your medical information to the correctional institution or law enforcement official. We may release your health information for your health and safety, for the health and safety of others, or for the safety and security of the correctional institution. Authorization. Other uses and disclosures of health information not covered by this Notice or the laws that apply will be made only with your written permission. If you provide our facilities with an authorization to use and disclose health information about you, you may revoke that permission at any time by sending a request in writing to the facility’s Health Information Management Department or Privacy Office. These include the sale of your health information, use of your health information for marketing purposes and certain disclosures of psychotherapy notes. You may revoke your authorization in writing at any time, and we will discontinue future uses and disclosures of your health information for the reasons covered by your authorization. We are unable to take back any disclosures that were already made with your authorization, and we are required to retain the records of the care that we provided to you. YOUR RIGHTS REGARDING YOUR MEDICAL INFORMATION Although your medical record is the physical property of our facilities, you have the following rights regarding medical information we maintain about you: Right to a Copy of this Notice. You have the right to receive a copy of this notice of privacy practices. We will post a copy of our current Notice in our facilities and on our website. A copy of our current Notice will be available at our registration areas or upon request. To request a copy of our current Notice of Privacy Practices, please contact the privacy office listed below. Right to See and Copy your Health Record. You have the right to see and receive a copy of your medical information. Usually, this includes medical and billing records, but does not include psychotherapy notes. To see and copy your medical information, you must submit your request in writing to the Health Information Management (Medical Record) Department of the facility where you were seen. If you request a copy of the information, we may charge a fee for the costs of copying, mailing, or other supplies associated with your request. You may request an electronic copy of this information, and we will provide access in the electronic form and format requested if it is readily reproducible in the requested format. If not, we will discuss the issue with you and provide a copy in a readable electronic form and format upon which we mutually agree, depending on the information and our capabilities at the time of the request. You may also request that we send your health information directly to a person you designate if your request is in writing and clearly identifies both the person designated and an address to send the requested information. If you agree, we may provide you with a summary of the information instead of providing you with access to it, or with an explanation of the information instead of a copy. Before providing you with such a summary or explanation, we first will obtain your agreement to pay the fees, if any, for preparing the summary or explanation. We may deny your request to see and copy your medical information in certain very limited circumstances, such as when your physician determines that for medical reasons this is not advisable. If you are denied access to medical information, we will tell you the reasons for the denial and explain your right to have the denial reviewed. Right to Amend your Medical Record. If you feel that your medical or billing information is incorrect or incomplete, you have the right to request that we add an amendment to your record. Your request must be in writing, and it must contain the reason for your request. To request a correction to your medical record, you must complete a “Request for Amendment of the Medical Record” form available in the Health Information Management (Medical Records) department of the facility where you received treatment, or the Privacy Office listed below. We will make every effort to fulfill your request usually within 60 days. We may deny your request to amend your record if the information being amended was not created by us, if we believe that the information is already accurate and complete, or if the information is not contained in records that you would be permitted by law to see and copy. If we deny your request, you will be notified in writing usually within 60 days. Even if we accept your amendment, we will not delete any information already in your records. If your request is denied, you have the right to submit a Statement of Disagreement which will be included in your medical record. Right to an Accounting of Disclosures. You have the right to request an “accounting of disclosures.” This is a list of some of the disclosures we made of your medical information. This list is not required to include disclosures made for treatment, payment, and health care operations, and certain other disclosure exceptions. You must submit your request in writing to the Luminis Health’s Privacy Office. Your request must state a time period that may not be longer than six years prior to the date of the request. Your request should indicate in what form you want the list, for example: on paper or electronically. The first list you request within a 12-month period will be free. For additional lists, we may charge a fee as permitted by law. Right to Request Restrictions. You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or healthcare operations. You also have the right to request a limitation on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. We are not required to agree to your request and will notify you if we are unable to agree. Your request must be made in writing to the Luminis Health’s Privacy Office. You may request that we not submit your medical information to a health plan or your insurance company, if you, or someone on your behalf, pays for the treatment or service out-of-pocket in full. To request this restriction, you must make your request in writing prior to the treatment or service. In your request you must tell us the information you want to restrict and to what health plan the restriction applies. If we do agree with your request, we will comply with your request unless the information is needed to provide emergency treatment. Right to Confidential Communications. You have the right to request to receive communications from us on a confidential basis by using alternative means for receipt of information or by receiving the information at alternative locations. For example, you can ask that we only contact you at work or by mail, or at another mailing address, besides your home address. We must accommodate your request if it is reasonable. You are not required to provide us with an explanation as to the reason for your request. If you would like to receive copies of medical information after your treatment, you will specify the method and location that information should be sent to you. Contact Information If you believe your privacy rights have been violated, you may file a complaint with the Luminis Health Privacy Office using the contact information below. You may also file a complaint with the Secretary of the Department of Health and Human Services. We will not retaliate against you for filing a complaint. If you have questions about this Notice, please contact the Luminis Health Privacy Office. Privacy Officer Luminis Health, Inc. Belcher Pavilion Suite 203 2001 Medical Parkway Annapolis, MD 21401 Phone: (833) 543-8442 (toll free) Fax: (410) 481-3729 [email protected] CHANGES TO THIS NOTICE We reserve the right to change the terms of this notice, and the changes will apply to all information we have about you as well as any information we receive in the future. We will post a copy of the current notice throughout Luminis Health and on our website. In addition, each time you register at, or are admitted to, the hospital for treatment or healthcare services as an inpatient or outpatient, we will offer you a copy of our current Notice in effect.
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