Common Contracts
1 similar Information Exchange Agreement contracts
Agreement for Exchange of InformationInformation Exchange Agreement • August 11th, 2021
We provide healthcare as a team of parents/guardians, doctors, nurses, dentists and educators. We also want to protect student and family confidentiality to comply with the Privacy Act of 1974. If you sign this form, you give permission for the individuals/agencies below to discuss your child's needs and share physical and mental health information. If you have any questions or comments, please call the Clinic Coordinator at (319)631-3204.
