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AMERICAN HERITAGE SUMMER DAY CAMP HEALTH SERVICES FORM / EMERGENCY CONSENT PERSONAL AND CONFIDENTIAL In order for our staff to properly care for your child, we ask that this form be completed on both
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Combined medical-201415-1 is a form used to report medical expenses for the year 2014-2015.
Employers and insurers are required to file combined medical-201415-1.
Combined medical-201415-1 should be filled out with accurate information about medical expenses incurred during the specified period.
The purpose of combined medical-201415-1 is to report and track medical expenses for tax and record-keeping purposes.
Information such as total medical expenses, name of the insured individuals, and dates of service must be reported on combined medical-201415-1.
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