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Pediatric Medical History Form Legal Name:DOB:Date:Preferred Name (if different from above): Who lives in children household? Adopted? Foster Child? N Family History (Blood Relatives)Any other adults

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What is who lives in childs?

Who lives in childs refers to the individuals who reside with a child or children.

Who is required to file who lives in childs?

Parents, legal guardians, or caregivers of the child/children are required to file who lives in childs.

How to fill out who lives in childs?

To fill out who lives in childs, you need to provide the names and relationship of each individual residing with the child/children.

What is the purpose of who lives in childs?

The purpose of who lives in childs is to identify all individuals living with the child/children for legal and logistical purposes.

What information must be reported on who lives in childs?

The information that must be reported on who lives in childs includes the names and relationship of each individual residing with the child/children.

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