div class=ts-pagebutton class=gotoPage data-page=1Page 1button div class=ts-imageimg data-url=ring-ilovepdf-employees-signature-the-witness-signature-and-witness-namehtmlpage=1 data-page=1 class=ts-thumb lazyload alt=Page 1: medicalofficedk¦ring-ilovepdfEmployees signature: The witness signature and witness name in typed letters: F CONSENT TO COLLECT MEDICAL INFORMATION I hereby agree that relevant loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentsmxreader030viewer20220402015e66b9254a0957377450855ahtml5thumbnails1jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=2Page 2button div class=ts-imageimg data-url=ring-ilovepdf-employees-signature-the-witness-signature-and-witness-namehtmlpage=2 data-page=2 class=ts-thumb lazyload alt=Page 2: medicalofficedk¦ring-ilovepdfEmployees signature: The witness signature and witness name in typed letters: F CONSENT TO COLLECT MEDICAL INFORMATION I hereby agree that relevant loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentsmxreader030viewer20220402015e66b9254a0957377450855ahtml5thumbnails2jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=3Page 3button div class=ts-imageimg data-url=ring-ilovepdf-employees-signature-the-witness-signature-and-witness-namehtmlpage=3 data-page=3 class=ts-thumb lazyload alt=Page 3: medicalofficedk¦ring-ilovepdfEmployees signature: The witness signature and witness name in typed letters: F CONSENT TO COLLECT MEDICAL INFORMATION I hereby agree that relevant loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentsmxreader030viewer20220402015e66b9254a0957377450855ahtml5thumbnails3jpg width=140 height=200 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letters: F CONSENT TO COLLECT MEDICAL INFORMATION I hereby agree that relevant loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentsmxreader030viewer20220402015e66b9254a0957377450855ahtml5thumbnails5jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=6Page 6button div class=ts-imageimg data-url=ring-ilovepdf-employees-signature-the-witness-signature-and-witness-namehtmlpage=6 data-page=6 class=ts-thumb lazyload alt=Page 6: medicalofficedk¦ring-ilovepdfEmployees signature: The witness signature and witness name in typed letters: F CONSENT TO COLLECT MEDICAL INFORMATION I hereby agree that relevant loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentsmxreader030viewer20220402015e66b9254a0957377450855ahtml5thumbnails6jpg width=140 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typed letters: F CONSENT TO COLLECT MEDICAL INFORMATION I hereby agree that relevant loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader030vdocumentsmxreader030viewer20220402015e66b9254a0957377450855ahtml5thumbnails8jpg width=140 height=200 divdiv