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Immunization Form Name - Minnesota Department of …

Immunization Form Name - Minnesota Department of …

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not to sign, it will not affect the health or educational services your child receives. I agree to allow my child’s school to share my child’s immunization documentation with Minnesota’s immunization information system: *Health care practitioner is defined as a licensed physician, nurse practitioner, or Signature: Date: physician ...

  Health, Department, Immunization, Minnesota, Minnesota department of

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