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Get Bellevue College Health Care Verification Form 2014

Scription of student/patient s condition and how it prevents the student from attending the college (attach additional sheets if necessary) INSTRUCTIONS TO HEALTH CARE PROVIDER: In order to consider an appeal for refund of tuition and fees, Bellevue College requires documentation from a licensed health care provider verifying a current condition that prevents the student from attending Bellevue College during this quarter. Step 1: Student signs consent section of this form Date of first visi.

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