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Note: If you have lived in Ohio for less than 5 years, an FBI check may be required in addition to BCI. Please check the appropriate box based on your residency status.

Client Consent: I, hereby acknowledge and provide my consent for Gracelove Pharmacy to collect my fingerprints for the purpose of conducting Ohio BCI and FBI background checks as indicated in this intake form. I understand that the information collected will be used solely for the specified purpose and in compliance with all applicable laws and regulations.

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