To better protect your family and privacy we have updated our parental consent forms. We recognize that there are times when your schedule doesn’t allow you to bring your child to his or her appointment, and want to be able to provide uninterrupted care during these visits. The updated form allows you designate person(s) to approve necessary x-rays, their cost, and acknowledge treatment plans recommended by the doctor on behalf of your child. We will include the form in your child’s chart and it will remain active until you specify otherwise. Please download the form to fill out and either send with your child to the appointment, or scan and email to firstname.lastname@example.org.
Click here to download.