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Form B COMPLETE BOTH SIDES OF THIS FORM AND RETURN TO RECEPTION OF BUILDING 15 PRIOR TO YOUR APPOINTMENT UNIVERSITY HEALTH SERVICE (U.H.S) CONSENT FOR THE COLLECTION OF PERSONAL INFORMATION The U.H.S

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If any signatures or authorizations are needed, make sure to sign and date the document in the designated areas on both sides. Follow any additional instructions regarding witness signatures if applicable.

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Complete both sides of refers to filling out all required fields on a document or form on both the front and back sides.

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