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HEALTH SCREEN & PERMISSION FORM Trap Vaccine Please answer the following questions about the person to be vaccinated. Full Name:Date of Birth:/ / Age: Gender:MF School: Street Address:Town/City: Zip
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How to fill out health screen amp permission

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It is important to check with the relevant authority or organization to determine if you are required to fill out this form.

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Health screen amp permission is a form that allows individuals to report their health status and give permission for health screenings.
Individuals who are participating in health screenings or programs that require reporting of health information.
Health screen amp permission can be filled out by providing accurate information about your health status and signing the permission section.
The purpose of health screen amp permission is to ensure that individuals are informed about their health status and give consent for health screenings.
Information such as current health conditions, medication, allergies, and contact information may need to be reported on health screen amp permission.
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