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Jersey Health Declaration Form

The Jersey Health Declaration Form is a form that outlines the conditions that you have and their diagnosis. It also specifies treatment procedures that have been completed. You will need to provide your name, social security number, physician's name, and whether or not you are a citizen of the United States. The form will help the doctor determine your medical history and the treatment required for the condition. The Jersey Health Declaration Form is an important part of your health care.

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