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Get CIEE Physician Medical Report Form

S the applicant displayed any of the following? Please explain. a. difficulties in relations with parents, authority figures, peers b. behavior disorders c. symptoms such as eating disorders, mood swings, depression, severe sleep disorders, unusual degree of anxiety, fear, or guilt To your knowledge, are there any predisposing medical, surgical, or emotional factors that may under stress or duress during the program present a need for immediate therapy while abroad? Please explain. NO  .

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