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Physician Order for Diet Modification
500 Main Street, Eau Claire WI 54701Part I To be completed by parent/guardian:
I hereby request that my child, (Name of Child)
receive a modified diet as prescribed
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What is university of wisconsin-eau claire?
University of Wisconsin-Eau Claire is a public university located in Eau Claire, Wisconsin. It is part of the University of Wisconsin System.
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Students, faculty, and staff at University of Wisconsin-Eau Claire are required to file the necessary forms for tax purposes.
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