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STUDENT HEALTH FORMS Daniel Boone Elementary School 2019-2023
Nurse. Office of Student Health and Wellness 42 West Madison Chicago Illinois 60602 Telephone 773-553-3560 Fax 773-553-1883 Student Medical Information 2019 2020 This form must be updated and returned to school each school year. My child has a primary doctor. YES NO If yes please provide the healthcare provider s name and phone number Name Phone number I give permission for my child s school nurse or designee to talk to the doctor about my child s health. If your child has a health condition...
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