APPLICATION FOR SUNSCREENING MEDICAL EXEMPTION ...
APPLICATION FOR SUNSCREENING MEDICAL EXEMPTION SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS, PROVISIONS OF LAW, AND FEES. ... Total or Fa cial Vitiligo, or Xeroderma Pigmentosum, or other Autoimmune Disease or other medical condition, which requires a limi ted exposure to l ight, and I qua lify for the medical exemption certificate provided ... ................
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