SIGN

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SIGN

Please fill out this form to sign and show your support for the Nova Scotia Declaration. Identifying information will not be shared without your express consent. Please only sign once per person to ensure integrity of the Declaration.

Email *

Prefix *

First Name *

Last Name *

First 3 Characters of Postal Code

Province / Country *

Signing as a: *

Concerned Citizen

Medical Expert (MD, Epidemiologist, Immunologist etc...)

Other Medical Practitioner

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