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SCHOOL PERMISSION CONSENT FORM



RE: Permission Form for HEALTH APPOINTMENTS DURING SCHOOL HOURS


I, the parent/guardian, do hereby give permission to Holistic Elevation LLC Staff to visit my child during school hours.


In addition, I also grant permission for my child’s academic records, along with his/her social, legal and behavioral information to be provided to Holistic Elevation staff, as he/she helps  my child to become a productive student and community member. Holistic Elevation team will work collaboratively with the school, community, parents and other factoring agencies, along with my child to ensure he/she develops to their full capacity. 


Feel free to contact me for further information.


تم تحديد وضع الرسم. يتطلب الرسم استخدام الماوس أو لوحة اللمس. لإمكانية الوصول إلى لوحة المفاتيح، حدد كتابة أو تحميل.

*This consent is valid until client discharge.


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