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Get Illinois Cornerstone Informed Consent Form

CORNERSTONE INFORMED CONSENT FORM Name of Participant Last First M Date of Birth Male Month Day Female Year Participant s ID Number It is important that you read the following. If there is anything that you do not understand or if you have any questions be sure to ASK. Welcome to Cornerstone a system that collects data on a wide range of health care services to individuals. These services include WIC Women Infants and Children Immunizations Case .

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