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Huntington’s Disease
(Groups of 4)
Teacher |
School |
Rec’d |
Prep |
Del |
Ret |
Assistance |
|
|
|
|
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Class # |
Students/class |
Sets |
1 |
||
2 |
||
3 |
||
4 |
||
5 |
||
6 |
||
total |
Number |
Equipment/Supplies |
|
DME KIT: |
|
Gallon Deionized Water |
|
|
|
HD Dye Kit: |
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|
|
|
|
Teacher evaluation |
Rec/d by teacher ___________________________ _________________
Signature date