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Get GA Barrow County School District Physical Consent & Insurance Form 2012-2024

P: Telephone# C / W / H: School: WBHS WBMS RMS AHS HMMS WMS Date of birth: Age: Sport(s) 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? Yes No If yes, please identify specific allergy below. Medicines: Pollens: Food: Insects: Explain "Yes" answers below. Circle questions you don't know the answers to. GENERAL QUESTIONS Yes No 1. Has a doctor.

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