• COVID-19 Health Declaration Form (Phase 3)

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  • In signing below, I, an individual over the age of 18 of sound mind, knowingly, voluntarily, and freely agree to this Declaration, and in doing so represent the truthfulness and veracity of the above answers.

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  • COVID-19 TREATMENT RISK INFORMED CONSENT FORM

  • I UNDERSTAND THE EXPLANATION AND HAVE NO MORE QUESTIONS AND CONSENT TO THE PROCEDURE

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  • Should be Empty: