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Rock Walworth Comprehensive Family Services, Inc. Head Start and Early Head Start 1221 Henry Avenue, Beloit WI 53511 Phone: (608) 2991500 or 18007747778 Fax: (608) 2991629 Permiso del Padre/Tutor
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Es un formulario de consentimiento para evaluación en español.
Debe ser presentado por el paciente o su representante legal.
Se debe completar con la información requerida y firmado por todas las partes involucradas.
El propósito es obtener el consentimiento del paciente para realizar la evaluación.
Se debe reportar la información personal del paciente, el motivo de la evaluación y el consentimiento para realizarla.
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