Emergency Release Form

When leaving your child under someone's care, this "Release for Emergency Treatment" form allows Condell to administer emergency care to your child when you are unavailable. Of course, emergency care will always be administered in situations of life-threatening illness or injury. In the event medical care is needed, the use of the authorization form will assure treatment without delay. Just complete the form and leave it with the person you have chosen to temporarily be responsible for your child. Click below to download the form.

Emergency Release Form (PDF: 37k)