Special Instructions

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• Allergies: _______________________________________

• Bedtimes: _______________________________________

• Off-limits TV shows: _______________________________________

• Snacks: _______________________________________

• Approved videos _______________________________________

• Medical Consent ^[*]

  ^[*] You might also consider having an emergency medical consent form available at your pediatrician's office. In the case of an emergency, the doctor would be able to fax the consent form to the hospital or medical center and your child would receive any emergency treatment needed.

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