Patient Name:DOB:Form filled out by: Mom Dad Guardian Other: 2025

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Parent or guardian means the mother or father of a person under eighteen years of age or one who is legally appointed to the care and management of a person under eighteen years of age or of a person incapable of managing his or her own affairs.
The term parent includes a legal guardian or other person standing in loco parentis (such as a grandparent or stepparent with whom the child lives, or a person who is legally responsible for the childs welfare).
Parental responsibility is exercised by the childs parents. Guardianship is exercised by someone who is not one of the childs parents. It is up to the person or persons with parental responsibility, or the guardian, to make decisions about the childs care and upbringing and to administer the childs property.
Take care of their child, Maintain contact with the child, Be a guardian to the child, and Make sure that the child has financial support. This means that both parents must provide for the childs needs.
Parent Signature means the act of a parent or guardian providing their written approval on a document.
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Parent/Guardian means a birth or adoptive parent, legal guardian, or other person having responsibility for, or legal custody of, a child.
A guardian is a person who is appointed to look after another person or his property. He or she assumes the care and protection of the person for whom he/she is appointed the guardian. The guardian takes all legal decisions on behalf of the person and the property of the ward.
Legal guardians have the same rights as biological parents, but a legal guardian is not always a childs mother or father and may or may not be related to a child by blood. For example, a grandparent might be appointed a childs legal guardian if for some reason a childs mother and father cannot care for a child.

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