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Permission Slip & Curative HIPAA Authorization Form for Minors
Conway School District - you should receive a copy of form after submitting
Conway's COVID Guidelines:
https://www.smore.com/putk7-10-25-22
Newsletter about testing:
https://www.smore.com/zr5mg-testing-for-the-flu-a-b-and-covid
If you would like to opt out of COVID/Influenza testing, please fill in your students information below and select "no" on the next page.
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* Indicates required question
COVID-19 & Influenza Testing Permission Form
Email Address
*
Your answer
Student/Athlete Name (only enter student name here, you will have the opportunity to list other students in the next section)
*
Your answer
Student/Athlete Birthdate
*
MM
/
DD
/
YYYY
Do you have additional students/athlete you need to give permission for?
*
Yes
No
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