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[DOCX File]Confidential - Colorado Kids With Diabetes
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Child's Name:_____ Describe the child's personality and temperament in relation to his/her age. Where appropriate, include a description of the child's usual disposition, his/her interaction with adults and other children, any unusual personality traits or habits, and any special needs which the child may have.

[DOC File]HEALTH INFORMATION ABOUT YOUR CHILD
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I give my consent for my child’s Health Care Provider and Child Care Provider/School Nurse to discuss the information on this form. ... Blood Pressure (if > 3 Years) ... Type …

[DOC File]Health Record****************************
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Blood Glucose Monitoring: Student is able to check as needed during the school day. ... I give my permission to the school nurse and other designated staff to perform and carry out the diabetes tasks as outlined in this School Health Plan and for my child’s health care provider to share information with the school nurse for the completion of ...

BLOOD TYPE CHART_CHILD FATHER MOTHER-PATERNITY determi…
Child’s Name (Last) (First) Gender. Male Female Date of Birth / / ... PREVENTIVE HEALTH SCREENINGS Type Screening Date Performed Record Value Type Screening Date Performed Note if Abnormal Hgb/Hct Hearing ... For lead screening state if the blood sample was capillary or venous and the value of the test performed.

[DOCX File]Virginia Department of Health
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Type of Insurance your child has: Medicaid No Insurance Private Insurance ALLKIDS Other: _____ Authorizations: I authorize the school nurse, the registered nurse (RN) or licensed practical nurse (LPN), to talk with the physician(s) should a question come . up about my child’s medical conditions.

[DOCX File]CH-14, Universal Child Health Record
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The above child is to be cared for in my day care home. State regulations require that each child's medical history, along with a current immunization certificate, showing that the child is immunized in accordance with American Pediatrics Association.

[DOC File]I agree to allow my child ...
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One or more aspects of vaccination (I.E. Blood polluting ingredients, cruelty to animals, cells originating from aborted fetal cells, etc.) are in violation of one or more doctrines of at least five (5) of the world's major religions. (Christian, Judaism, Islam, Buddhist and Hindu.) It is an uncontested scientific fact that a . minimum of 90%

[DOC File]CH-14, Universal Child Health Record
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This blood sample is only a method of keeping a sample containing your child’s DNA available in the care of an emergency requiring identification of your child. Your child’s DNA will not change over the course of his or her lifetime. DNA testing methods; however, do change. The type of test performed today might be outdated in the future.

[DOCX File]Grandparent Medical Consent Form - For a Minor Child
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What will it involve for me/my child? [Where 1st sample taken is equivalent to standard care] We will use a small amount of the blood that has been/will be taken as part of your/your child’s normal treatment to find out if it is possible for you/them to participate in this research. This extra amount will be less than ½ …

[DOC File]State of New Jersey
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born on the ___ day of _____, 20___ do hereby consent and allow _____ [Grandparent] to handle any type of medical care for my child including but not limited to the administration of anesthesia determined by a physician, surgery, and any other care recommended or deemed as necessary for the welfare of my child.

What is my child s blood type