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Having a third party present is recommended for the genitourinary examination. Notes Name of physician print/type Date Signature of physician MD or DO CLEARANCE FORM Cleared without restriction Cleared with recommendations for further evaluation or treatment for Not Cleared for All sports Certain sports Reason Recommendations EMERGENCY INFORMATION Allergies Other Information WCA Summer Practices Workouts June 2014 Sunday Monday Tuesday Wednesday Thursday Friday Saturday Indoor Soccer 1-3p...
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