Medical ConsentMedical Consent • May 18th, 2020
We, the Parents of , give permission for emergency medical treatment of our child for illness or accident if we cannot first be contacted. Emergency Parent or Guardian: Name: Phone: Office: Mobile: Email: Emergency Secondary Contact: (other than parent) Name: Phone: Office: Mobile: Email: Relationship: Does your child have any allergies or require special medication: Yes: No: Explanation:
