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Yes No 11. Did you personally fill out this form. Yes Application for Independent Living Admission The Village North Hampton Westwood Regency I II Wellington I II III IV No If no name of person who assisted you Address Phone number 1. Yes No Have you signed advance directives living will DNR etc.. Yes No If yes please provide copies. NOTE This application does not obligate Friendship Retirement Community or the applicant in any manner. If this application contains an untruth with reference...
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