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Kenalog consent form

This sample consent form for Kenalog addresses the off-label status of intravitreal injection of this drug.

RECOMMENDATIONS: Kenalog and Triesence intravitreal injections.

PREVENT WRONG EVENTS: Time out before Intravitreal Injections

 

 

____________________________________________                    ___________________

Patient’s Signature                                                                                                   Date

 

 

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