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PREVENTIVE CARE ASSESSMENT FORM FOR CHILDREN AND ADOLESCENTS Completed Form must be placed in record (if EMR scanned in record)Patient Name: D.O.B: / / Weight Assessment and Counseling for Nutrition
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The completed form must be a fully filled-out document required by a governing body, such as the IRS, that collects specific information from the filer.
Individuals or businesses that meet certain criteria set by the governing body, such as income thresholds or specific activities, are required to file the completed form.
To fill out the completed form, follow the provided instructions carefully, ensuring all required fields are accurately completed with the necessary information and documentation attached.
The purpose of the completed form is to collect specific data needed for tax reporting, compliance, or regulatory purposes, which assists the governing body in monitoring and enforcing laws.
Information required typically includes personal or business identification details, financial data, and any relevant supplemental information needed to support the filing.
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