Physician Release

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Ideal Protein Physician Release To Participate

Program Basis

The below named mutual patient is requesting to start the Ideal Protein Weight Loss Management Program which is monitored weekly in our office. We would like to have your medical clearance for him/her to start. Please provide your clearance responses below.

About Ideal Protein Program

ago this protocol was developed
0 Years
dieters have been successful with it
0 + million
health professionals across North America currently recommend the program

Ideal Protein Program Phases


Our cooperation

Physician Release Form

Physician Release to Participate

  • Patient’s info
    • MM slash DD slash YYYY
  • Physician’s info
  • About patient’s health
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