Epstein Secrets

MILY PHYSICiAN (46) PHYSCIAN PHONE (48) Does your child currently have health Insurance? 0 YES 0 NO If YES. Indicate (47) HOSPITAL PREFERENCE p Medicaid 0 Private • Healthy Kids, l60 Care ID interested In receiving information PARENTS/GUARDIAN'S OTHER CHILDREN IN PALM BEACH COUNTY SCHOOLS (49)

limited or immature. Unrelated information may be included. Frequent errors in punctuation, capitalization, and spelling may impede communication. Description of Grade 10 Writing Scores 6.0: The writing focuses on the topic, is logically organized, and includes substantial development of supporting ideas or examples

Y PHYSICIAN (46) PHYSICIAN PHONE (48) Does your child currently have health insurance? MI YES 0 NO If YES, indicate: (47) HOSPITAL PREFERENCE 0 Medicaid 0 Private 0 Healthy Kids/kQd Care 0 Interested In receiving information ASWALOA491.4:04iiit lit filierAlaffiblikr0S-1-101)1; . .. (49) NAME CF

errors in punctuation, capitalization, and spelling may impede communication. U: The writing is unrelated to the assigned topic or cannot be read. Description of Grade 10 Writing Scores 6.0: The writing focuses on the topic, Is logically organized, and includes substantial development of supporting ideas or examples

um fluoride program (Permission is valid (hmugh grade 6) YES (27) Does your child currently have health insurance? 0 YES 0 NO If YES, indicate: 0 Medicaid 0 Healthy Kids/Kid Care 0 Private (29) NOME LANGUAGE SURVEY (Chock so that Appy) 0 A language other than English Is used in the home. 0 The stude

limited or immature. Unrelated information may be included. Frequent errors in punctuation. caprulization, and spelling may impede communication. Description of Grade 10 Writing Scores 6.0: The writing focuses on the topic, is logically organized. and includes substantial development of supporting ideas or examples