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Get NYC Preparticipation Physical Evaluation Form 2019

In the the student s medical file.) Date of Exam Date of Birth Last Name Sex First Name Age Grade OSIS# Sport(s) School School Campus Medicines and Allergies Please list all of the prescription and over-the-counter medicines and supplements (herbal and nutritional) that you are currently taking. Do you have any allergies? q Yes q No If yes, please identify specific allergy below: q Medicines q Pollens q Food q St.

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