• Adult Consent / Medical Form

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  • Emergency Contact Details

  • I agree to provide to provide all my medical reports to LMHG for further review on my condition/s by Dr. Chintana Bounthalasay.


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  • Testimonials and Promotional Consent

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  • CONSENT FORM

    For 18 years and above adults with ability to give consent.
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  • CONSENT FORM

    For parent(s)/guardian(s) of minors without capacity of consent.
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