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Parental Consent Forms

When your child is with another caregiver, you know they are in good hands - but what if a medical situation arises? It is important to make sure to give all caregivers permission to seek medical assistance for your children. By completing this form you are granting permission for Hendricks Regional Health to provide medical assistance if it becomes necessary when your child is being cared for by someone else.

Click here to access the form in English.
Click here to access the form in Spanish.