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Department of Education MEDICAL CLEARANCE FORMStudent Name: Date of Birth: Date: Home Address: Mailing Address: Father/Guardian: Mother/Guardian: Home Phone: Home Phone: Work Phone: Work Phone: Cell
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The document is a medical clearance form for exercise.
Individuals who plan to start an exercise program.
One must provide personal medical history, current medications, and any known medical conditions.
The purpose is to ensure safety and suitability for physical activity.
Personal medical history, current medications, and any known medical conditions.
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