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PH: 3137490370 FX: 3134472234 Authorization for Treatment 1. I give Dr. Warmest permission to conduct the following procedure(s): Hand Injection Knee Injection Wrist Injection Hip Injection Elbow

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PH 313-749-0370 FX 313-447-2234 is likely a reference to a specific form or document related to regulatory compliance or tax reporting, though the exact nature is not specified.

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