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Get and Sign CLOVERLEAF LOCAL SCHOOLS EMERGENCY MEDICAL 2016-2022 Form

Get and Sign CLOVERLEAF LOCAL SCHOOLS EMERGENCY MEDICAL 2016-2022 Form

Use a CLOVERLEAF LOCAL SCHOOLS EMERGENCY MEDICAL 2016 template to make your document workflow more streamlined.

Physician Phone Number Address Preferred Dentist In the event the preferred practitioner is not available I give consent for treatment by another licensed physician or dentist and the transfer of the child to Preferred Hospital OR TO ANY HOSPITAL REASONABLY ACCESSIBLE. This authorization does not cover major surgery unless the medical opinions of two other licensed physicians or dentists concurring the necessity for such surgery are obtained prior to the performance of such surgery PLEASE CHECK...
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