Dr 353 2025

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4.8 out of 5

84 votes

The document is a 'Statement of Health Care Expenses' that requires parents to list health care expenses, including details such as the date of service, provider name, patient name, amounts charged and paid, and any outstanding balances. It also instructs parents to attach relevant documentation for each expense and provides a section for court use.

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Versions	Form popularity	Fillable & printable
2016	4.8 Satisfied (84 Votes)

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