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1 l y12RELEASE & INDEMNITYAGREEMENT I hereby agree to indemnify and release Patrick, Inc. and Apple Knoll Farm, and all associated persons, employees, agents, and representatives from liability for
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Dom Schramm Clinic Apple is a health clinic founded by Dom Schramm.
Patients or individuals seeking medical services at the clinic may be required to fill out forms related to their treatment.
Patients can fill out the forms by providing accurate and up-to-date information about their medical history, symptoms, and contact details.
The purpose of the form is to gather essential information about the patient to ensure proper diagnosis and treatment.
The form may require information such as personal details, medical history, current symptoms, insurance information, and emergency contacts.
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