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Pink Oyster Mushrooms

Record data

Birthday
Month
Day
Year

Emergency contact Person

Medical History Data

In order to find out if you're fit for this procedure, please answer the following health questions truthfully. YULE Smart Beauty and it's practitioners will assume no liability in the event you give false information to obtain the treatment.

Do you have any of the following conditions?
Date
Month
Day
Year

I'm responsible for all information here provided and I authorize the procedure.

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