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Phillip O. Berry Academy of Technology “Consent to Treat” Form

September 2021

Instructions:

All students wishing to receive a COVID-19 vaccine need to complete the “Consent to Treat” form, have the parent/guardian sign the form and bring the completed, signed form to the vaccine event at Phillip O. Berry Academy of Technology.

Click to Download Form (English)

Click to Download Form (Spanish)

 

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Charlotte, NC 28208

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Phillip O. Berry Academy of Technology

 "Consent to Treat" Form

https://www.livechatalternative.com/