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O. A. PHONE NO. NOTE A COPY OF THIS POWER OF ATTORNEY MUST BE PRESENTED AT TIME OF ADMISSION IF NO POWER OF ATTORNEY DOES ANYONE OTHER THAN YOURSELF HANDLE YOUR AFFAIRS IF YES WHO NAME DO YOU HAVE A CONSERVATOR IT IS THE REQUIREMENT OF ELCOR HEALTH SERVICES THAT THE ATTACHED FINANCIAL DISCLOSURE REPORT BE COMPLETED WHEN MAKING APPLICATION TO ELCOR HEALTH SERVICES. THIS REPORT MUST BE COMPLETED AND ATTACHED IN ORDER TO ACTIVELY BE PLACED ON OUR AD.

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