I, Full Name of Self/Parent/Guardian have read and understand the Embracing Abilities policies as laid out in the document above. I agree to adhere to these policies in regards to the services being provided for . I have been provided with a downloadable copy of these policies. I agree to the following policies that are detailed in this packet: Medical Emergency Consent, Authorization of use of E-mail and Facsimile for transmission of Personal Health information, Electronic Storage of Records, Use of texting, Home Attendance Pest policy, Attendance policy, and Medication Administration policy.Client NameDate