Common Contracts
1 similar Behavior Agreement contracts
BEHAVIOR AGREEMENT FORMBehavior Agreement • January 7th, 2014
As the parent/legal guardian of , I request in my absence the above name child or adult be admitted to any hospital or medical facility for diagnosis and treatment. I request and authorize physicians, nurses, dentists, and staff, to perform any diagnostic procedures, treatment procedures, and operative procedures to the above named individual. I have not been given any guarantee as to the results of any treatment if performed on the above named individual.
