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Get and Sign Initial Next to Each to Acknowledge SAFETY PRECAUTIONS!! 2018-2022 Form
Patient here before Y/N What year Under what name Blood Type Pos/Neg/Unkown Important Reminders Initial next to each to acknowledge Expect to be here 3-5 hrs Eat a light breakfast No greasy spicy or fried foods Wear comfortable 2-piece outfit pants shirt to be able to undress from the waist down. No rompers dresses or skirts. Appointment Date Appointment Time Time Change Y/ N Appointment Form Vac 450 5. 3 - 13. 6 wks Med 500 5. Bring a jacket. Wear full back underwear a pad can easily be placed...
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