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Release from Responsibility for Discharge Form, Full Page

SKU
MPSBRG-3025P
In stock
More Information
MPN 3025P
Packaging 1 per each
Size 8 1/2In x 11In
$31.77

    Note : Image shown for reference purposes only. Actual product appearance may vary. Please read product description for full and accurate details

    This form contains informationto release your facility from responsibility for a patient if he/she discharges themself from your facility against a physiciansand facility administrators advice.
    8 1/2" x 11", white paper, black ink, printed one side, 5-hole punched top and side, padded in 100s.
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