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The camp will call the prescriber as allowed by HIPAA if a question arises about the child and/or the child s medication. 11. Country in which the child resides 2. Attach Record of Immunizations Form DHMH-896 I certify the above information is correct and will notify Camp Aristotle officials should any information change. 2017 Camp Aristotle Forms and Information Prior to starting camp all families must complete the following. MD Prescriber s authorization Camp approval Signature Parts I and...
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