healthchiro.com - Minor Consent

CONSENT TO TREATMENT OF MINOR CHILD
I hereby authorize:
Dr. Name of Doctor and whomever he or she may designate as assistants to administer chiropractic care as deemed as necessary to my indicate relationship to child , Name of childDate at City State this Type a label day of Type a label , 20 Type a label .
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CONSENT TO TREATMENT OF MINOR CHILD