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SOCIAL SERVICES Children s Services 150 Main Street Cambridge, Ontario N1R 6P9 Telephone: (519) 883-2200 Fax: (519) 740-5957 MEDICAL REPORT FOR ASSESSING ELIGIBILITY FOR CHILD CARE SUBSIDY Sex: Male
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01
Start by entering your personal information at the top of the form. This includes your name, address, phone number, and email.
02
Next, provide details about your child. Include their name, date of birth, and any relevant medical information that may impact their eligibility for childcare subsidy.
03
Now, describe the reason for seeking childcare subsidy. Explain any special circumstances or needs that require assistance.
04
If your child has any medical conditions or disabilities, provide a thorough description of each. Include information on the diagnosis, treatment, and any accommodations or support required.
05
Attach any relevant medical documentation or reports that support your child's eligibility for childcare subsidy. This may include doctor's notes, test results, or therapist evaluations.
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Finally, sign and date the form to certify the accuracy of the information provided.
Any individual who is applying for childcare subsidy and needs to demonstrate their child's eligibility may require the docsadmin-1328200-v1-medicalreportforassessingeligibilityforchildcaresubsidy-cambridgeofficedoc. This could include parents or guardians who have children with medical conditions, disabilities, or unique circumstances that necessitate financial assistance.
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This document is a medical report used to assess eligibility for child care subsidy at the Cambridge office.
Parents or guardians applying for child care subsidy must file this document.
The document should be filled out with accurate medical information by a healthcare provider.
The purpose is to determine the medical eligibility of a child for receiving child care subsidy.
The report should include details of the child's medical condition and any special needs requiring additional care.
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