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Get the free Permission/Medical Release for Minors - Diocese of Joliet

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Rev 01/2022DIOCESE OF JOLIET Participant NamePermission/Medical Release for MinorsFIRSTLASTParent / Guardian 1Name Parent/Guardian 2Parent Caldwell Parent/Guardian 2Parent EmailParent / Guardian 1Teen
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How to fill out permissionmedical release for minors

01
Fill out the minor's personal information including full name, date of birth, and address.
02
Include the parent or legal guardian's contact information and signature authorizing medical treatment.
03
Specify any medical conditions or allergies the minor has, as well as any medications they are currently taking.
04
Include the name and contact information of the minor's primary care physician.
05
Sign and date the form to indicate that it has been completed and authorized.

Who needs permissionmedical release for minors?

01
Parents or legal guardians of minors who may need emergency medical treatment while under the care of another adult or organization.
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Permissionmedical release for minors is a legal document that allows a designated individual to make medical decisions on behalf of a minor.
Parents or legal guardians are required to file permissionmedical release for minors.
To fill out permissionmedical release for minors, you must include the minor's personal information, medical history, designated individual's contact information, and signatures from both parents or legal guardians.
The purpose of permissionmedical release for minors is to ensure that medical decisions can be made quickly and efficiently in case of emergency when the parents or legal guardians are not present.
The information reported on permissionmedical release for minors includes the minor's name, date of birth, medical conditions, allergies, current medications, insurance information, and emergency contact information.
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