Get the free I, the undersigned, do hereby agree and give my consent for Dr

CONSENT FOR CARE AND TREATMENT Patient Name (Please Print): I, the undersigned, do hereby agree and give my consent for Dr. Thirsted and associates to furnish medical care and treatment to my child,

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4. Fill in the relevant details regarding the purpose of the form, such as the reason for filling it out and any supporting documents required.
5. Double-check your entries to ensure they are correct and avoid any typos or errors.
6. If applicable, include any additional information or explanations in the designated section.
7. Sign and date the form in the appropriate space provided.
8. Review your completed form to ensure it is fully filled out and all required fields have been addressed.
9. Make a copy of the filled-out form for your records before submitting it.
10. Submit the form as per the given instructions, either by mail, online submission, or hand-delivery.

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