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Get missouri tattoo consent form

MISSOURI DEPARTMENT OF SOCIAL SERVICES MO HEALTHNET DIVISION CONSENT FORM MO-8812 NOTICE Your decision at any time not to be sterilized will not result in the withdrawal or withholding of any benefits provided by programs or projects receiving federal funds. CONSENT TO STERILIZATION STATEMENT OF PERSON OBTAINING CONSENT I have asked for and received information about sterilization from. All my questions have been answered to my satisfaction. SIGN.

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