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CERTIFICATE OF IMMUNIZATION
Unless specifically exempted by law, Tennessee law requires a certificate on file for each child in attendance in any school or child care facility in
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Green Hills Health Wellness Pharmacy, Inc., dba
Feb 8, 2017 The purpose ofthis letter is to refer to the Tennessee Board ofPharmacy (BOP) for appropriate follow up, the U.S. Food and Drug
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PH-4193 (Rev 3/19) RDA-10137
Must be completed by a health care professional based on patient preferences, patient best interest, and medical indications. To be valid. POST must be signed
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