Skip to content
  • Students
  • Alumni
  • Parents
  • Faculty
logo-main

Consent for Emergency/Medical Treatment

  • About SJHS
  • Admissions
  • Academics
  • Athletics
  • News
  • Calendar
  • Support SJHS
  • Jobs at SJHS
  • Buy SJHS Gear
  • Contact

Consent for Medical/Emergency Treatment

  • I/we, the undersigned parent(s)/guardian of (student name listed below), a minor, do hereby authorize treatment of my/our child by a licensed medical physician in case of any accident or illness that may so arise, or any hospitalization necessary.
  • Medical Matter

    Of the following statements pertaining to medical matters, sign only those in accordance with your wishes:
  • My child is taking medication at present. I will bring all such medications necessary, and such medications will comply with specific requirements on a separate form : “SJHS Medication / Indemnification Form” that has been completed. My child will administer his/her own medication in the office.
  • No medication of any type may be administered to my child unless the situation is life-threatening and emergency treatment is required.
  • This consent form will remain in effect until through the last day of school June 2020 for the care and treatment necessary to preserve the health of our/my child. We/I acknowledge that we are/ I am responsible for all reasonable charges in connection with care and treatment rendered during this period.
  • Student Emergency Information

  • Click the + icon on the right to add additional children
    First NameLast NameGradeDate of birth (mm/dd/yyyy) 
  • First NameLast Name# to receive school messages 
(emergencies, weather, etc.)Employer / CompanyHome Phone (xxx-xxx-xxxx)Work Phone (xxx-xxx-xxxx)Cell Phone (xxx-xxx-xxxx) 
  • First NameLast NameRelationshipPhone # 
logo-footer

800 Montana Avenue
Natrona Heights, PA 15065

Get In Touch!

724-224-5552
Fax: 724-224-3205

admissions@SaintJosephHS.com

©2022 Saint Joseph High School. All Rights reserved.

Site designed and maintained by: BIG Pixel Studio