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LEA Program Sample Nursing and School Health Aide Services Treatment Form
Attached are a SAMPLE
Nursing and School Health Aide Services Treatment Form, a SAMPLE
Progress Notes, and an
Instruction Sheet. The Treatment Form and Progress Notes were produced to provide guidance to LEAs to collect the information that may be required in an audit. The forms are provided in an unprotected and modifiable format, so that LEAs may customize them as needed.
Please note that these are sample documents and are not “official” DHCS forms.