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"text": "We require this form be returned to the address below within 30 days or no later than 14 prior to enrollment. All pages must be completed.",
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"text": "4. Send completed forms to: Student Health Services\nKentucky State University\n400 East Main Street\nFrankfort, KY 40601\nFax: (502) 597-6565 or\nScan to: Samantha.Todd@kysu",
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"text": "(Rev 6/19)",
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