Please complete the consent form in its entirety. If you or your child has insurance, make sure that you fill out the insurance section completely as well as attach a copy of the front and back of your insurance card. This ensures that we are able to appropriately bill your insurance for the services provided.
We're asking parents to submit this form prior to our first clinics on March 28 for Junior High or March 30 for Senior High.
If you have any questions at all or need assistance filling out the form, don't hesitate to call us at (573)335-7846.
|Immunizations Consent Form|