pain assesment
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…questions have been answered to my satisfaction.
I have been permitted to read this document and I have been given a signed copy of it.
I am at least 18 years old.
I am legally able to provide consent.
To the best of my knowledge and belief I have no physical or mental illness or weakness that would be adversely affected by my participation in the described project.
_______________________________________ __________
Signature of Participant Date
_______________________________________ __________
Signature of Witness Date
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