Medical Letter

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Medical Letter for foster/adopt parents to complete.

Published in: Health & Medicine, Business
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Medical Letter

  1. 1. MEDICAL LETTER Date: POTENTIAL FOSTER PARENT NAME: POTENTIAL FOSTER PARENT NAME: The above referenced individuals meet the following criteria: 1. is considered free of communicable disease; 2. has no known physical or mental condition which would be hazardous to, or impact negatively a foster or adoptive child; 3. is considered able to accept responsibility for a foster or adoptive child without risking his or her own health; 4. is physically and mentally capable to be verified as a foster or adoptive parent; and 5. You have performed a urine drug screen and the results are as follows or attached to this letter. Physician Name: Physician Address: Telephone #: THE CLIENT DATE THE CLIENT DATE Latest Revision 06/01/09 Page 1 of 1 file: CPA Policies/Forms/Parent Files/Medical Letter

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