Epstein Secrets

ROYAL PALM BEA , 411 Dear Customer, Florida Power & Light Company, P.O. Box 025576, Miami, FL 33102

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

ARGES PREVIOUS BALANCE TOTAL DUE t o Florida Power Light Company Miami, PO Box 025576 33102 PP

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 - -

ARGES PREVIOUS BALANCE TOTAL DUE t o Florida Power Light Company Miami, PO Box 025576 33102 PP

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 - -