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In addition program fees paid will not be refunded. I hereby agree to participate in the Sar-El hereafter the Program upon the express undertakings and acceptances which follow. Patient Last Name First name Age Sar-El Volunteers for Israel Program target date How long has the applicant been a patient of your practice MEDICAL HISTORY Allergies Medications Surgeries History of severe injuries Heart disease Angina Rheumatic fever Hypertension Congestive failure Diabetes Emphysema Asthma COPD...
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