Epstein Secrets

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

sician or Clinic Name: (Print or stamp) Address: Expiration Date: (15 days after ant inuntuthafteei appointment) hvsician or ignature: Date: Permanent Medical Exemption PART C For medically contraindicated immun exemption: DOE Code 3 tions, list each vaccine and state valid clinical reasoning or evidence for I ce

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 ideitcar examples

• (Print or Stamp) Address: Expirati0n Date' _Olitlazufttstualimaadzatisin atipSathunD *LI Physician or Authorized Signature. Date. Permanent Medical Exemption PART C For medically contraindicated immunizations, list each vaccine and state valid clinical reasoning or evidence for exemption: DOE Code 3 I c

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

an or Clinic Name: (Print or stamp) Address: Expiration Date: (r9 dart after nest humanization appo Physician or Authorized Signature: Date: Permanent Medical Exemption PART C For medically contraindicated immunizations, list each vaccine and state valid clinical reasoning or evidence for exemption: DOE Code 3 I c

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.

ic Name: 05•days after next immuilization.appoiutrnent) (Print or stamp) . . _ . . . • Physician or Address: Authorized Signature: Date: Permanent Medical Exemption PART C For medically contraindicated immunizations, list each vaccine and state valid clinical reasoning or evidence for exemption: DOE Code 3 I c

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

rvice Address: Riviera Bea L 33404 Phone: Expiration Date: (IS days after next Physician or Authorized Signatu A. 41/21-4goo/ w 7 3.0) •, Permanent Medical Exemption PART C For medically contraindicated immunizations, list each vaccine and state valid clinical reasoning or evidence for exemption: DOE Code 3 / c