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#251-278-2639
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Geneo Pre & Post Instruction Sheet
Daljeet Arora
2022-09-28T17:57:04+00:00
Geneo Pre & Post Instruction Agreement
Client Name
(Required)
First
Last
Consent
(Required)
I agree
I agree to communicate with my clinician about any changes, pre or post my Geneo application. By signing the below, I agree to follow all instructions to ensure the best outcome. I accept the risks & complications of the procedures and acknowledge pre & post instructions were provided to me.
Signature
(Required)
Date of Birth
(Required)
MM slash DD slash YYYY
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