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David Powell health history · I authorize Dr. David R. Powell and/or such associates or assistants as he may designate to perform those procedures as may be deemed necessary or advisable

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Page 1: David Powell health history · I authorize Dr. David R. Powell and/or such associates or assistants as he may designate to perform those procedures as may be deemed necessary or advisable
Page 2: David Powell health history · I authorize Dr. David R. Powell and/or such associates or assistants as he may designate to perform those procedures as may be deemed necessary or advisable