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Comprehensive Medical Form for Tony R. Romo

This form must be completed by a medical authority for Tony R. Romo. Please read and answer all questions accurately as of February 20, 2012. Your input is vital for Tony's health assessment.

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Comprehensive Medical Form for Tony R. Romo

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  1. ITEMS 1-11 MUST BE COMPLETED BY A MEDICAL AUTHORITY LEAVE BLANK

  2. READ ALL QUESTIONS AND CHECK AS IT APPLIES 20 Feb 2012 Tony R. Romo Tony R. Romo

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