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Get Indiana University Health Center Consent For Medical Treatment Of A Minor 2018

Iversity Health Center to provide prompt care to your son or daughter who has not yet attained the age of 18, we urge you to read and complete this consent form. Please return it to the Indiana University Health Center, 600 N Jordan Ave., Bloomington, IN 47405, Fax: 812-855-4628. In this way, we can help your child without delay should an emergency occur. I, , (Full name of parent/guardian) declare that I am the (Fa.

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