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All Signatures are valid for one year from the date written on this form. FINANCIAL POLICY AND SIGNATURE ON FILE During a Well Vision appointment a medical eye condition may be detected and or specialized
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All signatures are valid if they are genuine and meet the specified requirements.
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The person or organization responsible for obtaining the signatures is required to file all signatures are valid.
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All signatures must be filled out by hand by the individuals providing their signature.
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All signatures must include the printed name, signature, and date of the individual providing their signature.
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