div class=ts-pagebuttonPage 1button div class=ts-image amp-img class=ts-thumb alt=Page 1: Patient Health History Information Form - Family Cosmetic financial arrangements have been made you will be responsible for legal fees collection agency fees interest charges src=https:reader034vdocumentsnetreader034viewer2022052007601b87558a5672489232b20dhtml5thumbnails1jpg width=142 height=106 layout=responsive amp-img divdivdiv class=ts-pagebuttonPage 2button div class=ts-image amp-img class=ts-thumb alt=Page 2: Patient Health History Information Form - Family Cosmetic financial arrangements have been made you will be responsible for legal fees collection agency fees interest charges src=https:reader034vdocumentsnetreader034viewer2022052007601b87558a5672489232b20dhtml5thumbnails2jpg width=142 height=106 layout=responsive amp-img divdiv