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ConfidentialMedical Record Form Day Pupils This form must be returned to the Medical Center as soon as possible. ALLERGIES / SPECIAL NEEDS: (This box for Medical Center use only)Eastbound College

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Start by entering the date at the top of the form.

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Provide details of any symptoms you experienced during the day. Be as specific as possible and include the time and duration of each symptom.

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Medical record form day is a specific date designated for filing medical records.

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Medical information such as patient demographics, diagnoses, treatments, and outcomes must be reported on medical record form day.

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