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CHULA VISTA ELEMENTARY SCHOOL DISTRICT RECORD OF PRIOR SCHOOL PROGRAMS AND SPECIAL SERVICES Students Name: ID#: Grade: School: Teacher: Relationship to student: Mother Father Guardian Other (Specify)
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Start by carefully reading each question and providing accurate information about your child's condition or health status.
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Answer each question honestly and to the best of your knowledge. If you are unsure about any specific information, consult with a healthcare professional or refer to your child's medical records.
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Who needs does your child have:

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Parents or legal guardians who are responsible for the well-being and healthcare decisions of their children.
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Healthcare providers or professionals who require detailed information about a child's health condition or medical history in order to provide appropriate care or make accurate diagnoses.
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Educational institutions or organizations that may need information about a child's health status for enrollment, special accommodations, or emergency planning purposes.
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Child's medical information and conditions.
Parents or legal guardians of the child.
Fill out the form with the child's medical history and current conditions.
To provide necessary medical information for the child's care and treatment.
Child's medical conditions, allergies, medications, and any important medical history.
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