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CARROLL COUNTY SCHOOLS STUDENT HEALTH NEEDS IDENTIFICATION FORM Student Name: Homeroom Teacher: Physician: Section 1: Medical History (mark your answer with an X “) ADDYESNODIABETES×Estate of Birth:

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To fill out the msdhmsgovmsdhsitestaticcoronavirus covid-19 form for Mississippi, follow these steps:

02

Visit the MSDH website at https://msdh.ms.gov/msdhsite/_static/14,0,420.html

03

Scroll down to find the 'Coronavirus (COVID-19) Reporting Form'

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Anyone residing in Mississippi who suspects they may have been exposed to or are experiencing symptoms of COVID-19 needs to fill out the msdhmsgovmsdhsitestaticcoronavirus covid-19 form. This form is essential for reporting and tracking potential cases of COVID-19 in the state and ensuring appropriate public health measures can be taken.

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MSDHMSGOVMSDHSITESTATICCORONAVIRUS COVID-19 - Mississippi is a website providing information and resources related to COVID-19 in the state of Mississippi.

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