Epstein Secrets

• (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

do que han obtenido 5, 5.5 y 6. Los certificados no se otorgan basados en los resultados de los exámenes ceñidos a normas de aplicación nacional. Rapó FCAT (Haitian Creole) Yo bay de (2) rapo apa pou rezilta egzamen lekti ak ni ñatik FCAT la, youn se pou egzamen "Sunshine State Stantarde (SSS) yo, epl

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

do que han obtenido 5, 5.5 y 6. Los certificados no se otorgan basados en los resultados de los exámenes ceñidos a normas de aplicación nacional. Rapó FCAT (Haitian Creole) Yo bay de (2) rapo apa pou rezilta egzamen lekti ak matemat FCAT la, youn se pou egzamen "Sunshlne Siete Standard az (SSS) yo, ep

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

arto grado que han obtenido 5, 5.5 y 6. Los certificados no se otorgan basados en los resultados del FCAT ceñido a normas de aplicación nacional. Rapó FCAT (Haitian Creole) Yo prepare rapó apa pou egzamen lekti ak matematik, syans ak redaksyon FCAT bay swivan prensip Sunshine State Standards yo. Yo ek