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THOUGHTS Emotional Stresses Challenges Home Money Work Health Life Family ACKNOWLEDGEMENT CONSENT Patient Name Jason Park DC Family Advantage Chiropractic 2018 El Camino Real Santa Clara CA 408 571-6321 FrontDesk FAChiropractic.com www. In. lbs. Other Phone Emergency Phone CHIROPRACTIC HISTORY What would you like to gain from chiropractic care Have you ever visited a chiropractor What is their specialty Pain Relief Resolve existing condition s Overall wellness Both No If yes what is their...
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Of children refers to the documentation and information relating to dependent children that must be reported on a tax return.
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