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Neuroleptic Consent Signature

Neuroleptic Consent

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Your legal name

Your email address

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I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

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Audit

February 7, 2022 1:07 pm EDT

Neuroleptic Consent Signature Uploaded by Ajay Sood - drsood@drsoodmd.com IP 75.165.154.42