ATTENTION: This is a legal document. Please read carefully.
By signing, you agree that you understand and accept the terms in this form.
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If the client is 18 years of age or older, the client must sign and date the form.
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If the client is 18 years of age or older and is incapable of signing, a legally authorized substitute may sign and date the form.
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If the client is 17 years of age or younger, the client’s parent or legal guardian must sign and date the form, unless an exception exists under state or federal law.