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Get JFK Medical Center JFKN-600-10023 2017-2024

Completely understandable to me. I understand that my physician/surgeon may designate assistants, associates, residents, interns, technical assistants, and other health care providers as deemed necessary to assist him/her with the procedure(s) listed below. Name of Procedure(s): 1. 2. I have been fully informed and understand the potential benefits, risks and side effects of this care and also the likelihood of achieving goals related to this procedure. Any potential problems that might occur.

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