Contact Telephone Number. A Health Care Provider is a physician, physician assistant or registered nurse practitioner. I hereby give authority to any hospital or doctor to render immediate aid as might be required at the time for his/her health and safety. In case of injury or sudden illness, I request that this individual be called first: The following individual(s) may NOT remove my child from the facility: Name(s): Custody papers have been provided and are on file at the facility. yes no Telephone Authorization Code (optional):
Appears in 9 contracts
Samples: Financial Terms and Agreement, Global Minds Preschool Agreement, www.climbingtreeschool.org
Contact Telephone Number. A Health Care Provider is a physician, physician assistant or registered nurse practitioner. I hereby give authority to any hospital or doctor to render immediate aid as might be required at the time for his/her health and safety. In case of injury or sudden illness, I request that this individual be called first: The following individual(s) may NOT remove my child from the facility: Name(s): Custody papers have been provided and are on file at the facility. yes no Telephone Authorization Code (optional):
Appears in 2 contracts
Samples: cbelt.santancharterschool.com, missionmontessori.com
