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Web Use This Form As A Parent Or Guardian To Allow A Grandparent To Have The The Rights To Make Health Care Decisions On Your Child For A Temporary Period.
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Web Guardian’s Signature On A General Consent Form, Before Receiving Behavioral Health Services.
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Web Day Of _ _, 20 _ Signature Of Parent Or Legal Guardian _ _ Date Witness Signature Of _ And I Am Not , 20_ To _ Witness Name (Please Print) _ This Consent Form Should Be Taken.
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For Members Under The Age Of 18, The Parent, Legal Guardian, Or A Lawfully.
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