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Get Pacific Power Medical Or Life Support Equipment Certificate

Persons they care for. PATIENT INFORMATION and AUTHORIZATION (To be completed by the PATIENT) Name: Date of Birth: I authorize the release of this medical information to my potential employer and Ministry of Health appointed inspectors to ensure compliance with: the Residential Care Home and Nursing Home Act 1999, Regulations 2001 and Code of Practice and/or Ageing and Disability Services home care provider registration requirements or, the Day Care Centre Regulations 1999 and/or Child Care.

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