to bring the child to his or her medical appointment, and to consent to medical care which is deemed necessary by the physicians and medical providers at KAP at the time of the appointment. I understand that this delegation includes receiving health information about the minor necessary to make immediately necessary health care decisions.
By signing this form, I attest that I have personally read this form (or had it explained to me) and fully understand and agree to its contents.
This will be used for contact purposes only
Your message will be encrypted and can only be read by Kid Approved Pediatrics.