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

yo sétifika pou sa yo akonpil. Pou lekti ak Matematik, elév Id få gwo nät kl klase påbmans yo nan W°I° resevirfa sétifika. Pou redaksyon, tout elév kl fé nät 5.5 ak 6 ak tout elév klas 4vitm ki fe nöt 5, 5.5, ak 6 enema yon sétifika. Yo bay sétifika yo swivan nät elev yo få nan egzarnen ki baze sou "

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

s la. Shtifika FCAT Elév ki fé nät 5yém Nivo oswa elév ki fé gwo nöt kl pi plis pase 400 nan syans ap resevwa Sétifika pou Siksé. Yo bay tout elév kl fé nät 5.5 oswa 6 ak elév klas katriyém ki fé nöt 5, 5.5, ak 6 yon sétifika pou redaksyon. Yo pa bay sétifika swivan nöt elév fé nan egzamen kl baze s

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

atematik, elév ki lb gwo nöt ki klase pélémans yo nan 55" nita resevwa sétifika. Pou redaksyon, tout elév ki té nöt 5.5 ak 6 ak tot elév klas 4)." kl fé nöt 5, 5.5, ak 6 resevwa yon sétifika. Yo ba sétifika yo swivan not elév yo fé nan egzamen kl baze sou "modi egzamen ofisyål FCAT itilize pou få ev