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ConsentforCareandTreatment I, doherebyagreeandgivemyconsenttoEndurancePhysical Therapytofurnishmedicalcareandtreatmentconsiderednecessaryandproperintreatingmy physiciandiagnosedcondition. I, herebyassignallmedicalbenefitsfortreatmentprovidedintheclinictowhichIamentitled,
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The purpose is to provide a reliable and easily accessible duplicate of the original document.
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