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NHDHHSWICLocalAgencyClinicEvaluationGuide
AgencyandClinicSite:___Date:___Reviewer:___
Scheduledappointmenttime:___Start/entire/total time:___
Category:
Category:
Category:
Category:PG
Infant BF PP
Child
Childcare/recent
Cert/recent
Cert/recent
Cert/recertmidcertification
midcertification
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