Orange County NC Website
DocuSign Envelope ID:3E3FB60E-F222-4DA0-BB07-8BE54CB4F178 <br /> IN WITNESS WHEREOF, the Parties, by and through their authorized agents, have <br /> hereunder set their hands and seal, all as of the day and year first above written. <br /> ORANGE COUNTY: PROVIDER: <br /> OocuSigned Icy: D"uSigned by: <br /> By: �76in�n it a t 1^5 By: �aln tlt. C—aUWa� <br /> 8,i379948755E477.. 3EC6388978AI467 <br /> Janice Galloway, Fit Feet Nurse <br /> Printed Name and Title <br /> Revised 12/18 <br /> 7 <br />