Medical Release Form For Minor
A printable form on which a parent gives consent for medical treatment of a minor in case of emergency.
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Description
Medical Release Form
In case of emergency, I grant consent to {name} to authorize medical care for my minor child/children:
Our family doctor is: ____________________________
Allergies:____________________________
Contact me immediately at: ____________________________
Alternative contact name and number: ____________________________
Signature: ____________________________
Name: ____________________________
Address: ____________________________
Phone: ____________________________
Date: ________________
