Buffalo Gap Elementary
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Forms  
  Carla Kilpatrick

 
1. Name and Date
Fill in name and date
2. Age
Fill in age
3.
My favorite color is
red
blue
green
purple
brown
4. Visual Acuity
enter last known vision screening
20/20
20/30
20/40
20/50
5. allergies
what things are you allergic to
foods
plants
animals
drugs
other
 
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