To handle our enormous volume of school and camp forms, we ask the following:

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Prior to submitting your form(s), complete the following:

Patient Information/ Demographics

History of allergy or chronic medical illness

Past surgical procedures or hospitalizations

Name and dosage of each prescription medication

Particular restrictions in diet or physical activity

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Form fees are due upon submissio submission)

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Provide a stamped, addressed envelope for mailing

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Allow at least three business days for
form completion