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Our
flyer/announcement can be included with the Consent and Medical
History form as well as be printed for posting on your bulletin
boards.
You
may also print additional copies as a hand-out for use as
an announcement that we are on our way.
Consent/Medical
History Forms
 The
Consent/Medical history form is a two part form.
Page
one is the consent form. This gives us permission to treat
your child.
Page
two is the Health History form. This form makes us aware
of any diagnosis, medications and allergies that you or your
chilc may have.
Both
pages need to be filled out for your child to recieve care.
They are in Adobe Acrobat format. If you do not have Adobe
reader, you may get it here for free.
Our
Flyer
Consent/Medical
History Form
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