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