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Childcare Learning Centers Proof of Dental Exam form To be completed by the Parent (Please Print) Child s Name: Last First Middle Birthdate: Month/ Day/Year Address: Street City Zip Code Home Telephone.

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  2. Fill out the necessary boxes that are marked in yellow.
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  6. Look through the entire e-document to ensure that you haven?t skipped anything important.
  7. Hit Done and download your new form.

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