WebPhysical Examination Form Health Services Office May 5th, 2024 - Wolf Administration Warm Hand Offs Help Transition Overdose Survivors to Treatment Department of Health Urges WebMCH 213G reviewed 03/2014 1 I, (do ) (do not ) authorize my child’s health care provider and designated provider of health care in the school setting to discuss my child’s health concerns and/or exchange information pertaining to this form. This authorization will be in place until or unless you withdraw it.

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