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WASHBURN UNIVERSITY CHEERLEADING CLINICYOUTH CLINIC REGISTRATION AND WAIVER FORM (Please Print and Mail to Washburn University, Attn: Sherry Newell, 1700 SW College Ave.; Topeka, KS 66621 or call
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How to fill out youth clinic registration formdocx
How to fill out youth clinic registration formdocx
01
Download the youth clinic registration formdocx from the clinic's website or ask for a copy at the clinic.
02
Fill in your personal information accurately, including your name, date of birth, address, contact number, and emergency contact.
03
Provide information about your medical history, including any allergies, medications you are currently taking, and previous medical conditions.
04
Indicate any insurance information if applicable.
05
Sign and date the form to certify that all the information provided is accurate.
06
Submit the completed form to the clinic either in person or by mail.
Who needs youth clinic registration formdocx?
01
Anyone under the age of 18 who wishes to receive medical services at the youth clinic.
02
Parents or guardians of minors who are seeking medical services at the youth clinic on behalf of the minor.
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What is youth clinic registration formdocx?
The youth clinic registration formdocx is a document used to register youth for clinic services.
Who is required to file youth clinic registration formdocx?
Parents or legal guardians of youth who wish to access clinic services are required to file the youth clinic registration formdocx.
How to fill out youth clinic registration formdocx?
The youth clinic registration formdocx can be filled out by providing the required information about the youth seeking clinic services and signing the form.
What is the purpose of youth clinic registration formdocx?
The purpose of the youth clinic registration formdocx is to gather necessary information about the youth accessing clinic services and to ensure proper registration.
What information must be reported on youth clinic registration formdocx?
The youth clinic registration formdocx typically requires information such as the youth's name, date of birth, contact information, medical history, and insurance details.
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