Medical Permission Slip Template
Parental Information
Child's Information
Child's Medical Information
- In case of emergency and I am unable to be reached, I authorize medical treatment to be given to my child by a licensed medical professional. This authorization includes any necessary tests, procedures, or medications that the medical professional deems necessary for the treatment of my child's medical condition.
- I understand that the medical professional will make every effort to contact me or the emergency contact listed above prior to administering any medical treatment to my child, unless it is determined that immediate treatment is required.
- I certify that my child is not allergic to any medications and does not have any medical conditions that would prevent him/her from receiving medical treatment.
- I understand that this consent form will remain in effect until revoked by me in writing.
For medical professionals, it’s imperative to have permission slips and release forms for your patients to fill out — from medical record release forms to vaccination forms. With Jotform, you can easily build your own professional medical permission slip PDFs. All you need to do is include your information and applicable signature fields, then send the attached form directly to patients to fill out — their submissions will convert to PDFs automatically upon completion.
Customize your medical permission slips to work for your practice’s exact needs with our easy-to-use online builder. Drag and drop to pick fonts and colors, integrate with widgets, upload helpful videos or images, and more! Once you’re finished personalizing your permission slips, send them out via direct link, QR code, or by embedding it into your online patient portal or website.
Movie Permission Slip Template
Create movie permission slips for your student’s legal guardians to sign. Perfect for any school or organization. No coding. Works on all device types.
Field Trip Permission Slip Template
Generate handy field trip permission slip PDFs with Jotform. No coding knowledge is required. Works on iOS and Android devices. Perfect for teachers!
Basketball Permission Slip Template
Create basketball permission slips for your players’ parents to sign. Free and easy to customize. No coding. Works on all iOS and Android devices.
Summer Camp Permission Slip
Create summer camp permission slips for parents of your campers. Intuitive form building. Drag and drop to design. Works on desktop, tablet, and mobile devices.
Church Permission Slip Template
Gather permission slips for your next youth group event at church. Works on all mobile, tablet, and desktop devices. Drag and drop to personalize.
School Permission Slip Template
Generate PDF school permission slips seamlessly. Great for schools and camps. Works on smartphone, tablet, and desktop devices. No coding is required.
These templates are suggested forms only. If you're using a form as a contract, or to gather personal (or personal health) info, or for some other purpose with legal implications, we recommend that you do your homework to ensure you are complying with applicable laws and that you consult an attorney before relying on any particular form.