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DISTRICT 207 SCHOOLED HEALTH CENTER PARENTAL/GUARDIAN CONSENT FORM FOR HEALTH SERVICES Name of Student School ID# Last First School Freshman Ethnicity Sophomore Male Junior Senior Female Address Date
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How to fill out Amundsen school-based health center:

01
Obtain the necessary forms from the school or health center. These forms typically include personal information, medical history, and consent forms.
02
Fill in your personal information accurately, including your name, address, phone number, and emergency contact details.
03
Provide details about your medical history, including any pre-existing conditions, allergies, medications, and previous surgeries or hospitalizations.
04
If applicable, include any relevant information about your immunization records, such as the dates of vaccinations.
05
Review the consent forms carefully and sign them, confirming your agreement to receive healthcare services at the Amundsen school-based health center.

Who needs Amundsen school-based health center:

01
Students who do not have access to primary healthcare outside of the school setting may benefit from the services provided at the Amundsen school-based health center.
02
Students who require regular medical check-ups, vaccinations, or treatment for minor illnesses or injuries can seek assistance at the health center.
03
Students who prefer to receive healthcare services within the familiar school environment may choose to utilize the Amundsen school-based health center.
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The Amundsen School-Based Health Center is a facility located on the premises of Amundsen High School that provides healthcare services to students.
The staff at the Amundsen School-Based Health Center are responsible for filing the necessary paperwork for their services.
The Amundsen School-Based Health Center form can be filled out electronically or manually, and must include all relevant information about the services provided.
The purpose of the Amundsen School-Based Health Center is to ensure that students have access to healthcare services while at school.
The Amundsen School-Based Health Center form must include details about the type of services provided, number of patients seen, and any referrals made to outside healthcare providers.
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