PARENT/GUARDIAN CONSENT FOR
SCHOOL/CENTER HEALTH SERVICES
- This consent will remain in effect until your child transfers to another school, graduates or you indicate in writing that you wish to rescind this consent for school health services provided by the Health Program.
- When necessary, emergency health services such as first aid, cardiopulmonary resuscitation (CPR) or use of an automated external defibrillator (AED) will be performed until emergency services arrive on campus.
- Separate parent/guardian authorizations will be required for the health program staff or school staff to administer daily or as-needed prescribed or over-the-counter medications, conduct medical procedures or provide medical treatment.
- Telehealth services may be provided but all services require an additional medical consent form from our service provider
- THIS FORM MUST BE COMPLETED IF YOU CONSENT AND WISH YOUR CHILD TO RECEIVE ANY OF THE SCHOOL HEALTH SERVICES LISTED BELOW. PLEASE FILL IN ALL INFORMATION BELOW AND CLICK SUBMIT, OR CLICK HERE TO PRINT THE FORM TO BE COMPLETED AND RETURNED TO THE HEALTH OFFICE. CLICK HERE to submit the form online.