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Wellstar Medical Release  Form

Wellstar Medical Release Form

Use a Wellstar Medical Release 0 template to make your document workflow more streamlined.

To date Yes No Are there any medications this volunteer will be taking that might affect their service If so please list Comments Please sign below and return. Your reply will be held in confidence and is an important factor in considering this candidate. Sincerely Volunteer Services Print Physician s Name Doctor s Signature Date Address Phone Number Signature of Volunteer Applicant Signature of Parent/Guardian if applicable WellStar Douglas Volunteers 8954 Hospital Drive Douglasville GA 30134...
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