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Get Bcia 8572

Professional who is recommending accommodations on the bar examination for you on the basis of Attention Deficit/Hyperactivity Disorder (AD/HD). Please read, complete, and sign below before submitting this form to the qualified professional for completion of the remainder of this form. Applicant s full name: Date(s) of evaluation/treatment: Applicant s date of birth: I give permission to the qualified professional completing this form to release the information requested on the form, and I.

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