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Office Use: Time New Pediatric Patient Questionnaire Child's Full Name: Male Female DOB: / / Age Address: City, State, Zip: Height: Weight: Parent(s)/Guardian(s) Name: Parent Cell Phone: Home phone:
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Raising great children is a responsibility that involves providing love, guidance, support, and opportunities for growth.
Parents or legal guardians are required to file raising great children with.
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The purpose of raising great children is to ensure that children receive the necessary care, support, and resources for their growth and development.
Information such as the child's daily routine, education progress, emotional well-being, and any significant events or changes in their life must be reported on raising great children.
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