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Get And Sign MEDICAL RECORD RELEASE AGAINST MEDICAL ADVICE DA FORM 5009, FEB Armypubs Army 2004-2021

Get And Sign MEDICAL RECORD RELEASE AGAINST MEDICAL ADVICE DA FORM 5009, FEB Armypubs Army 2004-2021

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And my attending physician s. MEDICAL RECORD RELEASE AGAINST MEDICAL ADVICE For use of this form see AR 40-68 proponent agency is the Office of The Surgeon General. STATEMENT OF PATIENT RELEASING HOSPITAL/CLINIC FROM LIABILITY UPON LEAVING HOSPITAL/CLINIC AGAINST MEDICAL ADVICE 1. The potential medical risks that have been explained to me include 4. I hereby release the hospital/clinic its staff and the Federal Government of all responsibility for any ill effects brought about by my failure to...

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