CHILDREN 16 and 17 YEARS OLD
Many times parents or legal guardians (P/LG)find themselves unable to accompany their teen or young adult children to appointments. This form has been prepared for your convenience.
The following conditions must be in place:
1. Your teen must be responsible and mature and understand this is a continuation of care which has already been performed while a P/LG was present.
2. Credit card in on file.
3. P/LG is readily available by phone during appoitnment time.
4. Consent is received for antipated procedure/evaluation. Only the consented concerns below will be addressed.
5. Each and every visit must have a consented form for the for the visit and should be a chronic condition such as acne, warts or extractions (teen facial).
6. All regular conditions of office still apply and general consent will be needed ("Patient forms" consent on website)
7. The person filling out this form is the parent or legal guardian
Any new rash or skin cancer or mole concern will need all parties present.
Note: All inital visits need a parent or legal guardian present.