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Head Start age (35 years old) Center CHILD NAME Enrollment Date / / DOB / / Years Months Language: English Spanish Other SCREENINGS * Blood pressure: Date completed / / Reading / Staff initial * Height:
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It is a form used for center screening purposes.
All individuals working in a center or institution that requires screening.
The form should be filled out completely and accurately following the instructions provided.
The purpose is to ensure proper screening of individuals in center settings.
Personal information, screening results, and any relevant details.
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