I herby consent to give the docotr of chiropractic, and anyone working in the Excelsior Family Chiropractic offic authorization by the chiropractor, permission and authority to care for my child (the minor for whom this paperwork is for and for whom I am legally responsible). Chiropractic tests, diagnosis, analyasis, and adjustments are very safe, beneficial and rarely cause any risks. In rare cases, underlying physical defects, deformities or pathologies may make your child prone to injury. It is the responsiblity of the child's parent(s) / guardian(s) to make it known, or to learn through health care procedures if your child is suffereing from latent patholocial defects, illnesses, or deformities, which would otherwise not come to the attention of the chiropractor. The doctor of chiropractic will not give any treatment or care if he or she is aware that such care shoujld not be used for a particular condition or circumstances. Your child's doctor of chiropracitc is a licensed primary care provider, and is available to work with all other providers. I understand that following the doctor's recommended care plan is essential to maximizing my child's healing and reaching optimal health through chiropractic. Furthermore, any questions that I have regarding chiropractic care, will be explained upon my request.