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35:T434,36:T9a8,

Download your signed copy

37:T920,

Insurance Card EXample.png

38:T7be,

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View the signed consent

Field	On the chart	From the consent
Client First Name Client	Luke	Luke
Client Last Name Client	Skywalker	Skywalker
Client Gender Client	Male	Male
Client Date of Birth Client	2009-12-07	2009-12-07
Client Primary Language Client	English	English
Parent / Guardian Email Parent / Guardian	wickstephanie@gmail.com	wickstephanie@gmail.com
Parent / Guardian Phone Parent / Guardian	—	(980) 100-1000

Ticked fields overwrite what is on the chart. Rows already matching are left unticked.

3b:T449,

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Complete Admin related Intake Forms and Manage Client Consents

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