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Name of medication Special Health Care Planning - My child has special health care needs such as wheelchair tube feedings breathing tube catheter FK 6/12/17 intravenous tubes or other. LIFE THREATENING CONDITIONS Asthma Severe - If this box is checked please answer the following questions Yes No Does child use rescue inhaler routinely for asthma symptoms Yes No Has your child been hospitalized for asthma in the past year If mild or moderate asthma see box below Health History -Non-Life...
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