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Student
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Non-Binary
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Medical Condition
ADHD
Dysgraphia or trouble writing
Dyslexia or trouble reading
Dyspraxia (Muscle Control)
Peanut Allergy (Anaphylaxis)
Penicillin Allergy (Anaphylaxis)
OTHER (See Notes)
NONE
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ASD
Anxiety - Mild
Anxiety - Moderate to Severe (Panic Attacks)
Anaphylaxis (Please Include Action Plan)
Asthma
Auditory Processing Disorder
Medical Condition Notes / Other
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