General Consent
General Consent
If parents/legal guardians are not able to bring a child to an appointment they can sign a temporary consent that allows someone else to bring them such as stepparents, grandparents, and other caregivers.
Teenager Consent
Teenagers 16 years and older are able to come to appointments without the presence of an adult if parents/guardians sign the consent.
18 Year Old Release
Those 18 year old and older are legally adults. They must sign a consent for parents to have access to their medical history such as immunization records.
All forms must be manually signed and sent back to us PRIOR the appointment. Mail/fax to avoid delays or having to reschedule.
Parents/legal guardians are still responsible for paying amounts related to the visit. We reserve the authority to decide, in our sole discretion, to require a parent to be present regardless of any consent a parent may have signed.
Copays and insurance cards are required before each visit.
For transfers, please manually sign an authorization for release of medical records and upload it.