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FIDENTIALITY AGREEMENT DATE: HEALTH QUESTIONNAIRE CONSENT FORM FOR MINORS (IF APPLICABLE) BADGE ISSUED TITLE: EMPLOYEE: DEPARTMENT: TIME OUT: EXTENSION/PAGER: TIME IN: ADDITIONAL COMMENTS: TOTAL HOURS SHADOWED: BADGE COLLECTED JOB SHADOW CONSENT FORM FOR MINORS I understand that my child, , (a minor) participating in the Job Shadow program at Children s Hospital Central California. is I also understand that my child has requirements/responsibilities within this program, of w.

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