Children's Medical Report Form - Klingspor 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the child's name and birthdate at the top of the form. This information is crucial for identification.
3. Fill in the parent or guardian's name and address. Ensure accuracy as this will be used for communication.
4. In Section A, provide detailed medical history. Answer each question regarding allergies, current medications, and any previous hospitalizations. Use the text fields to elaborate on any 'Yes' responses.
5. Section B requires a licensed physician's examination. Ensure that this section is completed and signed by an authorized examiner, including height and weight measurements.
6. Complete the immunization history section by entering dates for each vaccine received. If necessary, attach a copy of the immunization record.
7. Finally, review all entries for accuracy before saving or sharing your completed form.

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