%PDF-1.5 % 10 0 obj <> endobj 24 0 obj <>/Filter/FlateDecode/ID[<9D76B5B4D97316409F8C3C01173CCD0B>]/Index[10 29]/Info 9 0 R/Length 76/Prev 26126/Root 11 0 R/Size 39/Type/XRef/W[1 2 1]>>stream hbbd``b`* ~@q3`Y $@>stream hb``a``aXT,  b> endobj 12 0 obj <> endobj 13 0 obj <>stream hެko0IK}R)I.zQ|0qj )dri ;rhQdl,^a{Q&NԆ1ֱK[#CI-SLG1uБ{H„ؿ46TCP}Kim ޷ac=?: endstream endobj 14 0 obj <>stream HtK0)b2]vMU]8$soo}g0!*JdfΙyi}v]'C7u 9~p)i>]v9i@V֥\k[悉2TyCrI=~&Lm0j4YĥLYK_T8 Gg2V`Pɤo;Q3Nh3)0Q(aF =M2\yĭN%IrsH2m|ؠmΎib V$0DJ=уh;$Na)ɪqƫ]+yqcs>stream HdMs0 Mzk6mL3i%9]q-I__f1HBP_&2e!r^0H매~p!=p#%nYuqEN[v~J3s7k_oӬ:zf vzgr+Ir_[Ɗ!ո}}B$?hTQ#jkUy]AwC>-ó}Q"JY48e엱(dlD} J6.CAڢ6=14 k&O"LqM /\ώo.;hfq+a7tSA+R`uT_ntpLN! bi#pB3)yefL.xMo WBY̹+W,&[^ )-w myH:5/%mf_]xǁE%%2!` ֛) .sx1 QK%1 54n sY'^H2i2uG}ˆPuND8)s͞yNЬ9R'm0< ƴ:ׇx[o,MxAv EG᳚PF3HͫBDZi5Ne4Ddy01\ ֍np_ URcF<$Fs +8$ íBs^snςBuSJT endstream endobj 16 0 obj <>stream H|So0~_qOȑ[l'#ڄ@!Vmmw{vڍ1h}X7kH* 'UC}L%m+fmnV0l3[Xhz?.QRP:Exѵ8 =alpg: 5yS%rܗCI9(s) 2X~>N@Jr, s Mɻ:kto(1Sp#"x92<~˾!65LӞ43(iLauS~,(XDƳRsNީbB˚^` Էaݡs~a)9T/lJ%rFOgMHrfwf7s3̥*qXQӰ60L氂uNQGG:ѲzFI}^sA Sz=vS3UNV 4h?h]jjtcUal$Դ$_67>'f./!y>~ .P uu#h<%JbeH jϴe%Q8"XıZF,) ƧJ&iX+"q/ ABQ+ gn4ᝯPP2@ s_5DE\g^R5"bfs=W!%Z z׍kӚoM endstream endobj 17 0 obj <>stream Hn0E ݐ MŷeH-]҅Ѝ ?REnF0Ds ޒ-1Y0AI*>(ZuCA7Tƀ4|QC] Z'.%5ƀԴTT/<Э6t;n-@1:o[6 Fo[]|#}2Lk 6vu:rg7z+ .b1Bڡ؏nO}Xu譳Y ^v$I0xOԘйÏn-K|≚T)  U^Dr7DxYr=.w=Ŋ|9 .KiBKpi8P>+ILj)[To/ύ<7BQyp6pX Cx3/&rpx8B{OpD~Q :Ne ^I| Vkw(8f܁8CrbDX`Uv9\Jǻ`43-@ID&Ծ$_&VhRdC9섘'15sDLfbqh-x29>V;9I]_#- endstream endobj 18 0 obj <>stream HTMo0 W4H+,RK Ào-ڒ8t,m"FAz||T|,,/Lh8H\%h,UL(dֵwT1N:Ӷvüdrƥ-zg-'Di&5He& k t.iBo@,(L˅v6bBΩd1Y2B-Ae¾%+&Ŋ@K,^/ŋQҠbSy =Gm߰6#ā-=)+"mITEʰqt}xj]k.ҙ챊v|:( z $H{l>stream HTMs0+( !NۙSnMF .w%vRb'U8&1%Tt'|h;\e:5h1c(!cڂ > |bᓑ,1Qjaj"nrŔ:Av;\3CZK Pb%5ÜxZtD:޷7+6%·?Q @Yˬ)JLX)JH^\ D8@x:Ň@)#5K  9\ ב\)&iss(1wi+ EQdHJvɯvc/ ffkDzTqKQa[*mGx iGgb9@ 6E4zk|4c=)B<6 "m8 /%@bp{ ),}J5- 6 /g%]۰}B=M5-H}ӝ0"B[TGaqQ ɱ°yhk~Оvi3n _uu"u_Bcer̢AXMiqJwn `K4s˾],;g'5' endstream endobj 20 0 obj <>stream HSr0:Ja# !r̸[qpKƎ3vN^O2d8HM2 " X/@[qm EqߕѠE ԐrHDԀ-G_ˎ (x? !0PXEaxV9cm43ohCO`th=0'qBdn1x 3u=ymCmwE2w|WCH9a 0ފϨeW7erz@O3_ʗ+7p&?xPi$_ѲybR++|n{ʁ'"&PK2Ȣ"~~Αp4ф ;۹Cobg,8YVklEkӍJ 2YzDjPV 7}{C$Kryk_2Ը$yI³I;tfQ~MS)./n܄VOF:>stream HTKo0W>ԞɭlE vA-]$Ŀg&Y'Bbǟg=oCKڕ~+ }W z 63lsS7*͈R׭ru`)A$tbĘy(mN3Qby6A wӻWS;i#$!! eWY {P;eA*H*H T 7ɱ/!"j./꽺\wVߕoyȮ0HX"Iމ$Z;HV$xs{e;3^/ 9A.oa>)1Gb780g`hP=k@Ilݿ= w#>stream hޜwTTϽwz0z.0. Qf Ml@DEHb!(`HPb0dFJ|yyǽgs{.$O./ 'z8WGбx0Y驾A@$/7z HeOOҬT_lN:K"N3"$F/JPrb[䥟}Qd[Sl1x{#bG\NoX3I[ql2$ 8xtrp/8 pCfq.Knjm͠{r28?.)ɩL^6g,qm"[Z[Z~Q7%" 3R`̊j[~: w!$E}kyhyRm333: }=#vʉe tqX)I)B>== <8Xȉ9yP:8p΍Lg kk Ѐ$t!0V87`ɀ2A. @JPA#h'@8 .: ``a!2D!UH 2 dA>P ECqB**Z:]B=h~L2  5pN:|ó@ QC !H,G6 H9R ]H/r Aw( Q(OTJCm@*QGQ-(j MF+ 6h/*t:].G7Зw7 Xa<1:L1s3bXyeb~19 vGĩp+5qy^ oó|= ?'Htv`Ba3BDxHxE$Չ"XAP44077&9$An0;T2421t.54ld+s;# V]=iY9FgM֚k&=%Ō:nc1gcbcfX.}lGv{c)LŖN퉛w/p+/<j$.$%&㒣OdxTԂԑ4i3|o~C:&S@L u[Uo3C3OfIgwdO|;W-wsz 17jl8c͉̈́3+{%lKWr[ $ llGmnacOkE&EEY׾2⫅;K,KhtiN=e²{^-_V^Oo§s]?TWީrjVQ=w}`嚢zԶiו8>k׍ E  [ly邟~_Y53rW򯎼^{7so}x>|쇊z>yz endstream endobj 23 0 obj <>stream Adobed     $$''$$53335;;;;;;;;;;  %% ## ((%%((22022;;;;;;;;;;;r"?   3!1AQa"q2B#$Rb34rC%Scs5&DTdE£t6UeuF'Vfv7GWgw5!1AQaq"2B#R3$brCScs4%&5DTdEU6teuFVfv'7GWgw ?T$:kkY]kGez}dMȪ9Wʪ: IZg>6pЇ-ǎ8 nϜܥ. d?]>GUWl^6Em{ ?7g`t>x.&PUbq"n|;&idrFd8IQ⺿֞ηn/L*>\o B[YRZK[\+wUJu47.r`~aj}#<+ӎyfDD(3Bpȵ߯mb8`ƥucz]KZ\]F9\DЄ8.s0g^d}vrޗXaiy-s+LJR\l4ޑձ[]V}Re1}>G6J Llﮨrˎ^H@ZP{T闚u9]79% W^`OGPD}+_SXq*fG4IOJ⾹v_ 4ϙ.ηn<I$JRI$I$$unnn[QCKqW8Z[Ǚ0S/>1_>c [v66Ï>>+R$JRI$dI$JSX/좑.?yIy8?[C <1t ?_\̓1n{F4ΎIOEdRp}V9TR$JRI&IK:JRI&IKI)I$JRI$IR.+nz'NơՐ\LΎ{_tu;juih5CINK3[u]0jDZi)I$JRJAyw:Xȶ~]Ʒ8C` )D*?=uR~^FMK쎥Dd$JRI$IR&\_Az̞u e&NSڤa}qWEnDZiw+IKI)I$^zB7dnvԔ(c\{~}}ٛkJq $IRukC_[^*J]$IJI$)tQџWEgkMwjﭴ}WƢ~@0@IO@gS'J}V?Y~YWو :ϊJzI%)$Ͼ.Ҿ]p+3osIO$e۫]'/?8N2;JJzۨS޿5;WjI$$I)I f3ܫ,h+ً궫}.uN:AikDܤy%:Y&~Y$[j×]W7ӆ50kis{_sAE5'oe.jp fm?>|Delsf6fttQ,ősN\){'}2icZ/ZOT~^&0nc!ppluӷA)hMtt,ȹJ 8x{B:n˵أZqiZ{u ~ 1#Q>!Ut>C^ %1"P$q[( <~PN{9ʷ+հi$˝P{> oș!@ N̟ dƓz=s_FnP_<|V=#NwN~5l(nj-Z^!ոgK~c/SS5?(AӃ3_Q 嗝Gc} 0?H%_nu< j܊«sZ !&!^-b|\&~<~Ϫ.YèZߢ7XUks~TIjKvoPxSsr)%xy"y*9EĆoQ1ٖ ]gK]k]c9^?vca2ˬd7tZOn AsGKV7*:޹`%̷HlIMonVծ/_4>  nVխ"I/y3p(έ`{Z@>+}{rn5[~,iFi}TNj󯯟Pp~4$zX/~YkB62lv'GFm'*o1>҃;K?%t,V WcYXinAY׺JA[MC5_WB{WUmNXe\7@5)e}+>dxM ~NFkNɝ+sI蘸RTI.^_o/ϬF^{}I.ṵY&8lqG o &Jǧ_:TݵT]\6 qm&@Ag#2mr$ m`+-uwJg-^0e0ZwcX#veYV[wZ쒘uҰio9,64Uz G6Zy2ǀM0DQ5WZ$@xbWe$ I{ϭ_ZqWKmYht_Sg[2ֻ?' <R-I >~v5ٓm#hvջqjDzK{?'.:gk"r:`y$WiSyaY+pO`a8/ؙnkel}];cִ\\$/7u`F׊[ noH{/[GF*kNsbo[Ymoaz{U+zo¿ʪTm1Oޒs}n:+&L.?f5O5̰uX_R붶m.-~g{NfoRSfNjs}&ZI?OiwԫWi;X`wp-Yz]z G.`L6jkO5IMW)z+ԯb/Iٷtloaslfhq3J}k|܃-pZ]c0w-kkȭ9kMmIM[?ŗtnULse`lwiwOUoWjm]p|ܼ_N5ykY_BJ}__4nEd<+ <:Kkxv?huodHOO{>t؍]S_kK&JJrz=Jϰ[a2پ~K2[gOJ6ם`fQŀb 9?z> t+~c: [K4 =r}&8v+}nC&GH4R^vuuXq/PlCcR3oIL~zX~B߬z[j鋜F<㾱Q_mGV$1vh.?~{./mU߬U}T,:?X| ~UYӲǻ"͌>M%$>fWX^iV3S cA%iyȩ@b~p>u٘7 i%eS?Vmَ=@fV;)[_YUQ#%h?NEY/ 2{$V?.[KsOcqZY~齃c'49*Iy8XYRg}75ܝC}g̢ڛ]mǓ>脔_=9[]?Ivcա{- _Һf%cW^Ѵ[}uv&m8۸JWS_c?"0WN5?Ϣ~gV5i*gMsֹ:HI,ל\ބ;o3Nwf,{[E x^E-]b@ ++/?77&Xm!CKItא(ǒ}xzf>v%YxMcƮ+$u3xfB-/K>C/&Uz߭tsc{[%\ָӡPsQ_G5 S[F;5>kFY]F^3,w8RNnWswMM[ NApKԭ߭_R:]ˍ=JgTwm\$ A趌_b>+}du]&VGGWimeG3zS͖-o+3:~UVP0oGXױ:Mm0Hcu/~6Sw/0@+ӺN9艹hyc` $t;#c w $X渶4;n4zECcUI)ټ~o$IO}r#rfk31YRgOmcsI Wīд!c3j"'_ rٜ2r3mfc kmGه_z|6쮼ΙN _wʁY]+dنCClsEdKbxs׺e}&Zu.i S 29bF&ጆ) kxכgL]c\~ӯ<0%;3J~9zQY7f.-fYUZGw] z>%cV纰\$yqZ{HsFXDn@oȡJ ZֈkD;[a"c3˙!...8Sl#JK-u]c~|~mG'3k1nן7. 3U67)w&{HُU8};!acmls}Nmt*I`6q.;rvNEXz zcS\Fs=vHxeCzX u7 -oq_7滮GMTcYڕ}Y=_?u0HC ds_`h'^&wCW|^4:VD >~ъMC๾:TہԳq݌2mTdT%%:>gJ$Wula#& .⏡D4/2l6YvL|L)93:#CU_\:mx$9]]37gחQ:79 )?Q1KO9zKt[Zd>X_Yz ʠ9o.S='mwbK0?5$4>qr!=SMec.p0eeOƥtB lˉ*ckЫh;XZ])ϻiB,mٴ=?|NSIe"e !ߪyuOQ:WY{7]Pu,s^ & 3@~DI:O[] +~u*eVY'Ȥ=_ZN: RZ#s:Dɧ^s[e~wWOuLX߳8^ ?SgԎ\2rD5%;}OUg[fXU}b? ֞fZ\!OGck]S  'p"\hgRhkMo$oRNʏafkzիzEV>Mۺn-2S? ;w_gQs浵$}StlM~/3\ϩ41'X?=ߞdO?)ZôIHcQ --<P+ 3c4kg_7-/tip'@Z_Dn'K?Bb?"&Rt+h)!?_?\s?﫫Σ3B?MG椧'^a2?#ʸy Kos*_Joo?_JO焔WS7;%e̜tَa,hlYUoJ]+v0HxIH?'.:gk"=+B]O?iyxƯ"SIzV$c3/-~E]?7S?BޡaY$?7ծf:VޛY1shaZ'h䤦_['굍e9Ǵ)@~,9ev4{}ǿ-]DV?Ihq=ȒnۿJq47 >%YC{ =%zjJGUߑyo/T+ԯb;/-39z{ IO.s[>c@ʹޝ'tk'+?2f%։;~I)SּVuNn=a[XZ:O_[:nOae .qpJ2&AuNpu WZJw)%ӿ !`3/?O}]=CqY BC?"H|#z_\_dYc//)?~vEGo[U7G}L򑟡WvI,~Q6\6aZ߇\/*X*| ,Vfa_[una_XxnFM7,Ca:GO5Ӕf \~LhcCh|JdfWX^fCj )gG^y9Oiy?w{$@o+ѻ'_ףn-Ƚd3sCAc3.-"rC,xѺ,>[_ܾe/~<`^u.srTz7;5_5I" )Uȵ/ Y=OʵZ60m [V鸛 IOCr?o?sQlf]xi|{cy@|M7)!_1OYKK7#?Ė7%=ZN]v:뵡5ڂ6^WC}C *A\kƆpJ|[2_Y\Ck[eE{4?WOڼ枸s-k͟arӕ׳n:1P߬Qֶ<qmfΝ1:6,쮭9KTfa" &-:*y?E_J2 ݼ+3"M}fk?Zg"*o7W?a2"ޟx|?'MVn4F m&%òdw2Gy2s\<@fLtVl^$#&oqۅ%wtez.'W4^!ZIh>>1|W-/r+[|ڝ. fKCm= NK^ޡ&V {d l5|чp6# Gև~| )=8bb~F k@[ ?Q:G~%gtޞ9K$Iڭ9sqw o+ ݇{9Eh$}腭sK\iAINhEh fw*ݘXYMo{4cA"<IK B ծe޻}ٝ+M$ºSu1ִ@%4IK*9 ?æ R \,L:,JYE?c^c\GQIK*;=z84;)$I<^ pyR~_@蹶zXTg;+A$KS_=v>JX44ab6]\u6z:I)XhZu(Q+mM:?r*I)Xxm2r~h]5c-p)E43e5s(݉{D$ݤ؈ ?m_`ՙ߰L$R 0,s_e5ф#=xeG{A$ ,CwiaShۇ{ŗRߢ4>RAi!:I)zgH.-,u`$FO__zFwEE$1h:ܯC;mwNy۬|YjwKw=9?V깻/mAwHp?td*phq}4;9$"A$7nt_`֙߰Ly8yLk2h7AǬ_ah>kJ@p ޿[Sh-piЃRI%!E2v3MZ^ր>h$}Z8i:^.22I5[~~g?=_Mh[duoXamRMѡ{,~z=?o7q]j [sŗRDytRB eRILXַ@ѠR=9f7Oޯbbab+)dccjȭXQRIM >l6EދoL\/.X<դRŅwމel4=еASI%5)]2ӋUo Z11Щn[?FI%#ogsc-p`6SI%,pwiakz:I)I$J@p h48h̨ӕS.ǀ$8=bU˘ވݑcToEtʴJ@Lw'FI$I%? endstream endobj 1 0 obj <>stream h2S0P0W0P+-q b".vv7 endstream endobj 2 0 obj <>stream application/pdf Microsoft Word - FHP PH UM Preauthorization form.docx u28976 2014-09-23T16:21:01-05:00 PScript5.dll Version 5.2.2 2014-09-23T16:21:01-05:00 Acrobat Distiller 11.0 (Windows) uuid:839d5b3a-e7bf-4d99-802e-6a8b8b63ca32 uuid:fe6d15bf-4b09-44f1-9fa1-767a01c1f811 endstream endobj 3 0 obj <>stream h޲P0Pw/+Q0L)64 T$ endstream endobj 4 0 obj <>stream h| 0F_n&iZ)K!OD Dܦ(>EN*?^"Hư0[8T`K&,/^|G endstream endobj 5 0 obj <>/Filter/FlateDecode/ID[<9D76B5B4D97316409F8C3C01173CCD0B>]/Info 9 0 R/Length 48/Root 11 0 R/Size 10/Type/XRef/W[1 2 1]>>stream hbb&0]&6 L@YA\F H02v endstream endobj startxref 116 %%EOF