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Page 1: eastridgemiddle.weebly.comeastridgemiddle.weebly.com/uploads/1/2/5/6/12568654/immunization_form.pdf · Rubella Varjcelta Tdap Booster Rotavirus ... A) Temporary - Expiration Date

Page 2: eastridgemiddle.weebly.comeastridgemiddle.weebly.com/uploads/1/2/5/6/12568654/immunization_form.pdf · Rubella Varjcelta Tdap Booster Rotavirus ... A) Temporary - Expiration Date

Tdap (Pertussis Booster) Requirement Sticker (PM 286 S ...Tdap stickers are to be completed by school sta˜, not by students or their parents. The Tdap sticker may be used to document

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