Get Allergy Station Release Of Antigen Consent Form

Filling out the Allergy Station Release Of Antigen Consent Form online is a straightforward process that ensures you or your child's allergy treatment is managed effectively. This guide provides clear, step-by-step instructions to assist you in completing the form accurately and efficiently.

Follow the steps to complete the form correctly.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the patient’s name in the designated field labeled 'Patient Name'. Make sure to provide the full name for accurate identification.
3. In the next section, fill in the 'Date of Birth' field with the patient's birthdate. This information helps in confirming the identity and age of the patient.
4. Proceed to request the allergy extract to be administered by indicating either your name or your child's name. This is essential for accountability in treatment.
5. Next, acknowledge the supervisory physician’s role by entering the name of Travis A. Miller, MD, which is already specified in the form.
6. You, as the patient or guardian, will need to provide your signature in the 'Signature of Patient' section to validate the consent.
7. Record the date of signing next to your signature in the corresponding field.
8. The supervising physician must then print their name in the section labeled 'Name of Supervising Physician' and provide their signature in the designated area.
9. Lastly, ensure the supervising physician dates their signature to confirm when the consent was given.
10. You will now be able to save changes, download, print, or share the completed form as needed.

Complete your forms online today for a hassle-free experience.