To Whom It May Concern,
Having seen _______________ as my patient since birth, I am confident in my formal diagnosis of _______________. As a result, _______________ should be given a 504 plan.
_______________'s medical needs include _______________. Components of a 504 plan for this child must include: _______________.
Please ensure that _______________ receives a safe and appropriate education and approve the 504 plan without hesitation.
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