{"version":"1.0","provider_name":"Susong Dermatology","provider_url":"https:\/\/susongderm.com","author_name":"derek@sceniccitystudios.com","author_url":"https:\/\/susongderm.com\/author\/dereksceniccitystudios-com\/","title":"One Time Authorization Form","type":"rich","width":600,"height":338,"html":"
One Time Authorization Form<\/a><\/blockquote>