Consent to Treat Minor Without Parent/Legal Guardian Present

If you would prefer to download a PDF version of this form and return it to the office, please click here.

  • To allow for treatment of patients who are considered minors, it is necessary for a parent or legal guardian to give consent for treatment. In the event that a minor child presents for a non-urgent appointment without a parent or legal guardian or a signed consent, treatment may be denied.

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Patient Forms
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