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Vision Services Consent, Release of Liability, and Authorization Form Parents please sign the vision consent and medical history forms if you want your child to have an eye exam and return to school
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How to fill out vision services consent release
How to fill out vision services consent release
01
Obtain the vision services consent release form from the vision services provider.
02
Fill out your personal information such as name, address, date of birth, and contact information.
03
Provide details about your vision services provider, including their name, address, and contact information.
04
Sign and date the consent release form.
05
Review the form to ensure all information is accurate and complete.
06
Submit the completed form to your vision services provider.
Who needs vision services consent release?
01
Anyone who is receiving vision services and needs to authorize the release of their information to another party, such as a different healthcare provider or insurance company, may need a vision services consent release.
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