Medical Authorization. In the event of illness or injury while participating in the above referenced activity, I hereby consent to whatever x-ray, examination, anesthetic, medical, surgical, dental diagnosis or treatment, hospital care and emergency transportation from a licensed physician, surgeon, and/or dentist as deemed necessary for my safety and welfare.
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Samples: instruction2.mtsac.edu, www.mtsac.edu, www.mtsac.edu
Medical Authorization. In the event of any illness or injury while participating in the above referenced activityinjury, I hereby consent to whatever xX-ray, examination, anesthetic, medical, surgicaldental, dental or surgical diagnosis or treatment, treatment and hospital care and emergency transportation from a licensed physician, surgeon, physician and/or dentist as surgeon is deemed necessary for my safety and welfare.
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Samples: Study Abroad
Medical Authorization. In the event of illness or injury while participating in the above referenced activity, I hereby consent to whatever any necessary x-ray, examination, anesthetic, medical, surgical, dental diagnosis or treatment, hospital care and emergency transportation from a licensed physician, surgeon, and/or dentist as deemed necessary for my safety and welfare.. Participant’s Medical Insurance Carrier Policy # Insurance Carrier Phone # In the event of an illness, accident, or other emergency, please notify:
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Samples: www.barstow.edu