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Directory Results for I, ,knowing that I may have a condition that requires diagnostic, medical or surgical treatment, do hereby voluntarily consent to such procedures (medical, surgical or other services) and care under the general or specific instructions of Dr Fred Wil to I, ,motherfatherguardian(circle one)

I, ,knowing that I may have a condition that requires diagnostic, medical or surgical treatment, do hereby voluntarily consent to such procedures (medical, surgical or other services) and care under the general or specific instructions of Dr Fred Wil
I, ,motherfatherguardian(circle one)