Epstein Secrets

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

core describes your performance on the lest and allows for comparisons from year to year. Reading Comprehension Scale Scores range from 527 to 817. Mathematics Scale Scores range from 568 to 863. The National Percentile Rank (NPR) and &lanais indicate your relative standing in comparison to the national reference group

nic Name: (Print or stamp) Expiration Date: (t5 days after next immunization appointment) 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

core expresses your performance on the test and allows for comparisons from year to year. Reading Comprehension Scale Scores range from 527 to 817. Mathematics Scale Scores range from 568 to 863. The National Percentile Rank and Stanine Indicate your relative standing in comparison to the national reference group. Nati

• (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

core expresses your performance on the test and allows for comparisons from year to year. Reading Comprehension Scale Scores range from 519 to 830. Mathematics Scale Scores range from 553 to 858. The National Percentile Rank and Stanine indicate your relative standing in comparison to the national reference group. Nati

Clinic Name: Expiration Date: (Print or sump) (15 days after next immunization appointment) 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 - -

Score descrbes your performance on the lest and allows for comparisons from year to year. Reading Comprehension Scale Scores range from 519 to 830. Mathematics Scale Scores range from 553 to 858. The National Percenlile Rank (NPR) and Stanine Indicate your relative standing In comparison to the national reference group

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

Score describes your performance on the test and allows for comparisons from year to year. Reading Comprehensbn Scale Scores range from 527 to 817. Mathematics Scale Scores range from 568 to 863. The National Percentile Rank (NPR) and Stanine indicate your relative standing in comparison to the national reference group

Clinic Name: Expiration Date: (Print or sump) (15 days after next immunization appointment) 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 - -

Score descrbes your performance on the lest and allows for comparisons from year to year. Reading Comprehension Scale Scores range from 519 to 830. Mathematics Scale Scores range from 553 to 858. The National Percenlile Rank (NPR) and Stanine Indicate your relative standing In comparison to the national reference group