I, the parent/guardian of this patient, give permission for my child to attend his/her medical appointments accompanied by another adult without my presence and authorize treatment for my child in accordance with the office policy of Current Dermatology and Cosmetic Center. I understand that office staff will not be able to convey the details of the appointments to me later in the day, rather, it is the responsibility of the adult accompanying my child to relay any diagnosis, treatment plan, or prescription(s) back to me as the parent or legal guardian. This guardian will also be responsible for providing a history of present illness and any needed protected health information. I agree to be financially responsible for all charges, copays, and coinsurance incurred in these visits.