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Clayton County Public SchoolsIndividual Health Plan Allergic ReactionSchool ___School Year ___Date ___Student Name: ___Allergies ___Date of Birth: ___Teacher: ___Grade Level: ___Parents/Guardian: ___Home Phone: ___Cell Phone (Mother): ___Work Phone (Mother): ___Cell Phone (Father): ___Work Phone (Father): ___Emergency Contact: ___NameRelationshipPhoneEmergency Contact: ___NameRelationship

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