Medical Consent Form For Grandparents


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How to write a Medical Consent Form For Grandparents? Download this Medical Consent Form For Grandparents template that will perfectly suit your needs.

Our collection of online health templates aims to make life easier for you. Our site is updated every day with new health and healthcare templates. By providing you this health Medical Consent Form For Grandparents template, we hope you can save precious time, cost and efforts and it will help you to reach the next level of success in your life, studies or work!

Cottonwood Pediatrics 700 Medical Center Dr, Ste 150 Newton KS 67114 316-283-7100 www.cottonwoodpeds.com Consent to Treat (For NON-PARENT caregivers of minor children when a parent is not present) TO AVOID DELAYS IN TREATMENT Please return this completed form by mail to the address above, or by fax to 316-283-7118, BEFORE the child’s appointment Child’s name Date of Birth When I/we, the undersigned parent(s) or legal guardian(s) of the child listed above, are not present, I/we authorize: who is Name of adult who is the NON-PARENT caregiver whom you are authorizing to give consent to treat to the child (grandparent, aunt, babysitter, etc.) and a caregiver of this child, to consent to any X-ray examination, anesthetic, medical or surgical diagnosis, immunizations, injections or treatment and/or hospital care to be provided to said child, when such services are recommended and supervised by Cottonwood Pediatrics..

This Medical Consent Form For Grandparents is intuitive, ready-to-use and structured in a smart way. Try it now and let this Medical Consent Form For Grandparents sample inspire you.

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