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

an. Rapó egzamen ofisyèl FCAT itilize pou fè evalyasyon (NRT) Rapb FCAT NRT a montre nbt lekti ak matematik nan vèsyon Florida genyen pou SAT9 la (Se Harcourt Educational Measurement ki pibiliye li.) Yo konpare nbt elèv la ak yon gwoup nbt yo konsidere kbm "modèl pou egzamen ofisyèl" la, kote swivan klas

• (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

u egzamen ki baze sou "modél egzamen ofisyél FCAT itilize pou få evalyasyon" yo prezante nät pou lekti ak matematik nan vésyon SAT9 Florida bay la. Se Harcourt Educational Measurement ki te pibliye vésyon sa a. Yo konpare nät elév yo ak yon gwoup nät yo 'considere käm "modél pou egzamen ofisyår la nan niv

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

an. Rapti egzamen ofisyél FCAT Rilke pou fe evalyasyon (NRT) Rapti FCAT NRT a montre nät lekti ak matematik nan vésyon Florida genyen pou SAT9 la (Se Harcourt Educatlonal Measurement ki pibiliye li.) Yo konpare nöt elev la ak yon gwoup nöt yo konsidere kem "modet pou egzamen ofisyél" la, kote swivan klas

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

an. Rapò egzamen of isyél FCAT hilka pou fè evalyasyon (NRT) Rapò FCAT NRT a montre nät lekti ak matematik nan vésyon Florida genyen pou SAT9 la (Se Harcourt Educational Measurement ki pibiliye li.) Yo konpare nät elév la ak yon gwoup nöt yo konsidere kärr' "modél pou egzamen of Isyét" la, kote swivan k

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

. Rapó egzamen ofisyèl FCAT itilize pou fè evalyasyon (NRT) Rapo FCAT NRT a montre nót lekti ak matematik nan vifisyon Florida genyen pou SAT9 Ia (Se Harcourt Educational Measurement ki pibdiye li.) Yo konpare no( elèv la ak yon gwoup nót yo konsidere kom "modèl pou egzamen ofisyèl" la, kote swivan klasm