STATE OF FLORIDA Page 1 of 2 School Entry Health Exam
DH 3040, 6/02 (Obsoletes previous editions which may not be used) Stock Number: 5744-000-3040-2 STATE OF FLORIDA School Entry Health Exam To Parent/Guardian: Please complete and sign Part I — Child’s Medical History. State law for school entry requires a health examination by a legally qualified professional. ................
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