3040 florida physical form

    • [PDF File]STATE OF FLORIDA School Entry Health Exam

      https://info.5y1.org/3040-florida-physical-form_1_81d1e8.html

      STATE OF FLORIDA School Entry Health Exam. Page 1 of 2. To Parent/Guardian: Please complete and sign Part I — Child’s Medical History. State law for school entry requires a health examination by a legally qualified professional.

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    • [PDF File]STATE OF FLORIDA Page 1 of 2 School Entry Health Exam

      https://info.5y1.org/3040-florida-physical-form_1_e0bc79.html

      DH 3040, 6/02 (Obsoletes previous editions which may not be used) Stock Number: 5744-000-3040-2 STATE OF FLORIDA School Entry Health Exam To Parent/Guardian: Please complete and sign Part I — Child’s Medical History. State law for school entry requires a health examination by …

      florida school health form 3040

    • [PDF File]Page 1 of 2 STATE OF FLORIDA School Entry Health Exam

      https://info.5y1.org/3040-florida-physical-form_1_be81ae.html

      (This form will be stored in the child’s Cumulative Health Folder and may be accessed by both school and health personnel.) Recommendations (Attach additional sheet if necessary): (Please Check One) This child may participate fully in school activities including physical education.

      hrs form 3040 florida

    • [PDF File]Florida School Entry Health Requirements

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      Florida School Entry Health Requirements School Entry Health Examination (School Physical) Form DH 3040 (Physical exam must have been performed within 12 months prior to registration) Florida Certificate of Immunization (Immunization Record) Form DH 680 (Must be used to document immunizations required for entry and attendance in Florida

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    • [PDF File]2019 School and Sports Physicals Resource Guide CRESTVIEW

      https://info.5y1.org/3040-florida-physical-form_1_5888bb.html

      Form 3040 for School Physical. Form EL2 for Athletic physical. *Has a Crestview location Emerald Waters Medical Clinic 1005 West College Boulevard, B, Niceville, FL 32578 (850) 279-6815 $45 $35 Appointmen t required Yes. *Patients 12 years and older only. *Medicaid - only taking Humana CVS Minute Clinic 4562 E Hwy 20 Niceville, FL 32578

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    • [PDF File]STATE OF FLORIDA Page 1 of 2 School Entry Health Exam

      https://info.5y1.org/3040-florida-physical-form_1_ea4e35.html

      Guide for Completing the School Entry Health Exam (DH 3040 Form) DH 3040, 6/02, Stock Number: 5744-000-3040-2 General Information Purpose: The School Entry Health Exam has been designed to meet the requirements for the school entry health examination, as mandated by s.1003.22, F.S. (formerly s. 232.0315, F.S.) for student entry into Florida

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