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The doctrine of informed consent requires that before a patient can be touched by a physician, he or she must give consent for the physician to proceed. Further, that consent is legitimate only if the patient understands the process he or she is about to undergo.
Patient privacy protection: A HIPAA authorization form allows patients to decide who can access their health information, promoting privacy and control over their medical records.
However, we may still request a court order to provide medical services if the childs health requires it and will investigate allegations of lack of medical care because of religious beliefs if the childs condition appears to involve medical neglect.
Purpose To enable parents and guardians to authorize the provision of emergency treatment for children who become ill or injured while under school authority, when parents or guardians cannot be reached.
Write a statement authorizing the medical provider to administer treatment and make necessary medical decisions. Specify any limitations or specific treatments that are authorized. Include the patients name, date of birth, and any relevant medical history, if necessary. Sign and date the letter.
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1. Requester: Only parents, relatives, or friends listed on the Student Emergency Information form will be allowed to pick up a student during an emergency or critical incident. You are required to show identification and sign out the student using this form.

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