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BRUNSWICK COUNTY HEALTH SERVICES COVID-19 VACCINE CONSENT FORM FRONT AND BACK PAGES MUST BE COMPLETED Child's Full Name: ___ Date of Birth ___/___/___Child's Age: ___Parent/Legal Guardian Name (please
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Brunswick County Health Services refer to the public health services provided by the county government to residents in Brunswick County, North Carolina.
All residents and healthcare providers in Brunswick County are required to file Brunswick County Health Services.
To fill out Brunswick County Health Services, individuals and healthcare providers must complete the required forms and submit them to the designated department.
The purpose of Brunswick County Health Services is to promote, protect, and improve the health and well-being of residents in the county.
Information that must be reported on Brunswick County Health Services includes personal health information, medical history, and any health services received.
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