Office of Children and Family Services | Home | OCFS
CHILD IN CARE MEDICAL STATEMENT. To Be Completed By Licensed Physician, Physician Assistant or Nurse Practitioner. Name of Child: Date of Birth: / / Date of Examination: / / Immunizations required for entry into day care. Medical Exemption. The physical condition of the named child is such that one or more of the immunizations would endanger ... ................
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