FORM Infant Water and Food Consent Form: Operations Page 1 of 1 Effective: 01/2017 Families providing homemade baby food must provide consent below. Baby!DedicationConsent!Form! Dear%Parent(Legal%Guardian):% Microsoft Word - baby-dedication-consent.docx Created Date: 5/27/2016 5:16:12 PM All passport applicants under 16 must apply in person using Form DS Form DS-3053 "Statement of Consent." You must submit the completed form with the child's Baby Glance 3D/4D Ultrasounds - Forms - Gender determination, 3D and 4D baby ultrasounds, Midland, Texas, also Odessa, La Mesa, Andrews, Big Springs and Lubbock. informed consent and request for vaginal delivery do not sign this form until you have read it and fully understand its contents patient's name_____ CONSENT TO INFANT CIRCUMCISION • Circumcision is an elective surgical procedure for removing part of the foreskin from the penis; it is available at this facility A Child Travel Consent form does not allow the parent or guardian to temporarily make medical decisions for your child or minor.
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