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THE GYNECOLOGY CENTER · PATIENT CONSENT AND AUTHORIZATIONS CONSENT FOR TREATMENT: l, the undersiåned patient, parent or legal guardian, do hereby present myself (or Initials the

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Page 1: THE GYNECOLOGY CENTER · PATIENT CONSENT AND AUTHORIZATIONS CONSENT FOR TREATMENT: l, the undersiåned patient, parent or legal guardian, do hereby present myself (or Initials the
Page 2: THE GYNECOLOGY CENTER · PATIENT CONSENT AND AUTHORIZATIONS CONSENT FOR TREATMENT: l, the undersiåned patient, parent or legal guardian, do hereby present myself (or Initials the
Page 3: THE GYNECOLOGY CENTER · PATIENT CONSENT AND AUTHORIZATIONS CONSENT FOR TREATMENT: l, the undersiåned patient, parent or legal guardian, do hereby present myself (or Initials the
Page 4: THE GYNECOLOGY CENTER · PATIENT CONSENT AND AUTHORIZATIONS CONSENT FOR TREATMENT: l, the undersiåned patient, parent or legal guardian, do hereby present myself (or Initials the
Page 5: THE GYNECOLOGY CENTER · PATIENT CONSENT AND AUTHORIZATIONS CONSENT FOR TREATMENT: l, the undersiåned patient, parent or legal guardian, do hereby present myself (or Initials the
Page 6: THE GYNECOLOGY CENTER · PATIENT CONSENT AND AUTHORIZATIONS CONSENT FOR TREATMENT: l, the undersiåned patient, parent or legal guardian, do hereby present myself (or Initials the

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