3. Student Information, Wellbeing & Behaviour

Date………………………………………………………………………….. Medical consent from Parent

TO:

FROM:

(Name of Parent/Guardian)

(Address)

Child’s Name:

Child’s Date of Birth:

I give permission for you to contact my doctor to provide with any relevant information and/or opinion regarding my child’s medical condition and whether the recent absences experienced can be medically authorised.

Name and address of Doctor:

Parent/Guardian’s signature:

Date:

N.B. Please note that

will not pay for medical advice

provided.