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ChildImmunform0814.ex 7/9/08 9:16 AM Page 2 Child Immunization Consent Form A. Personal information: Given Name Surname School Age Classroom # Grade Date of Birth 9-Digit Manitoba Health Number (PAIN#)

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What is routine childhood immunization consent?

Routine childhood immunization consent is a form that parents or guardians of children need to fill out to give permission for their child to receive routine childhood immunizations.

Who is required to file routine childhood immunization consent?

Parents or guardians of children are required to file routine childhood immunization consent.

How to fill out routine childhood immunization consent?

To fill out routine childhood immunization consent, parents or guardians need to provide their child's personal information, medical history, and indicate their consent for the specific immunizations.

What is the purpose of routine childhood immunization consent?

The purpose of routine childhood immunization consent is to ensure that parents or guardians are aware of and give their consent for their child to receive routine childhood immunizations for their protection against various diseases.

What information must be reported on routine childhood immunization consent?

On routine childhood immunization consent, parents or guardians must report their child's personal information (name, date of birth, etc.), medical history, and indicate their consent for the specific immunizations.

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