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IMMUNIZATION RECORDS REQUEST Kealing Middle School  Form

IMMUNIZATION RECORDS REQUEST Kealing Middle School Form

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Cualquier declaraci n que confirme la enferemedad de varcicela o Una copia de examen de sangre que compruebe inmunidad a la varicela Si su hijo ha tenido varicela favor de llenar la declaraci n de abajo puede llenarla el doctor padre o custodio legal y devolverla a la enfermera de la escuela o a la encargada de vacunas en la oficina de la escuela de su hijo a. Date Signature Relationship to student OR Confirmation of blood test showing Varicella immunity. Copy attached Physician/Lab FECHA...
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