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Office of Children and Family Services | Home | OCFS
- https://ocfs.ny.gov/main/Forms/Day_Care/OCFS-LDSS-4433.dot
- CHILD IN CARE MEDICAL STATEMENT. To Be Completed By Licensed Physician, Physician Assistant or Nurse Practitioner. Name of Child: Date of Birth: / / Date of Examination: / / Immunizations required for entry into day care. Medical Exemption. The …
Medical Statement of Child in Childcare - University at Buffalo
- http://ecrc.buffalo.edu/_docs/Medical-Statement-of-Child-in-Childcare.pdf
- statement from a parent, parents or guardian of the child stating that they object of the immunization of their child due to their sincere and genuine religious beliefs should be …
OCFS-LDSS-4433 Medical Statement of Child in Day Care
- https://www3.sunysuffolk.edu/forms/dss-4433.pdf
- Medical Statement of Child in Childcare (cont.) Summary of Physical Exam Include special recommendations to Day Care Providers On the basis of my findings as indicated …
Ohio Department of Job and Family Services CHILD …
- https://www.owens.edu/childcare/forms-findlay/child-med-statement.pdf
- CHILD MEDICAL STATEMENT FOR CHILD CARE Child’s Name (print or type) Date of Birth This above named child has been examined, the immunization status …
CCMPL 92 (JFS 01305 Child Medical Statement Second …
- https://emanuals.jfs.ohio.gov/ChildCare/ChildCareManual/CCMPL/CCMPL-92.stm
- The JFS 01305 "Child Medical Statement for Child Care" went through a second clearance to add recommended assessments, screenings and measurements. Effective …
Ohio Department of Job and Family Services CHILD …
- https://www.achildsgarden.us/assets/Medical-Form.pdf
- CHILD MEDICAL STATEMENT FOR CHILD CARE. Child’s Name (print or type) Date of Birth . Note: Sections A and B must be completed by the examining Health Care …
CHILD MEDICAL STATEMENT FOR CHILD CARE
- http://www.pediatricenter.com/assets/forms/ChildMedicalStatementChildCare.pdf
- CHILD MEDICAL STATEMENT FOR CHILD CARE Child’s Name (print or type) Date of Birth This above named child has been examined, the immunization status recorded, …
Office of Children and Family Services | Home | OCFS
- https://www.ocfs.ny.gov/forms/ocfs/OCFS-6004.docx
- MEDICAL STATEMENT Child Care Programs I nstructions A signature is required on BOTH SIDES of this form. If the only role is a household member, complete ony the front …
Child Medical Statement - Ohio Department of Education
- https://education.ohio.gov/getattachment/Topics/Early-Learning/Preschool-Licensing/Licensing-Child-Medical-Statement.pdf.aspx
- Child Medical Statement. Revised 3/12/2018. Section I - Child Medical Information. Child's Name Date of Birth Height Weight. Immunizations: Limitations or …
Medical Statement of Child in Childcare - Ymca
- https://cdymca.org/wp-content/uploads/2018/09/Medical-Statement-of-Child-in-Childcare.pdf
- Created Date: 2/10/2017 10:31:54 AM
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