Patient History Form for Mr Adrian Jones ND

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Please attach copies of any recent tests, Reports re biopsy, scans etc

I acknowledge that outcomes for this treatment may, or may not as yet be have been tested scientifically.

I acknowledge that no outcome is absolutely certain, and I agree to faithfully follow instruction in order to maximize positive outcome.

I undertake this treatment with no expectation other than to take the journey, and consider any outcome.

I acknowledge that I have read this disclaimer, and agree to it, and evidence the same just by returning this document to Mr Adrian Jones.

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