CONSENT TO TREAT MINORS

Physician Name: Jon J. Atiga M.D.

Address: 25405 Hancock Ave. Ste. 108 Murrieta, Ca 92562

General Consent to Treat-Minor Patient

I authorize the above stated physician, his associates, assistants, and other qualified medical personnel of his/her choice to treat my child, and recommend and/or order laboratory test or other specialized test as indicated for diagnosis of my child's medical condition.
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