By filling out this form, I approve that my (our) daughter/son (as typed below), has my (our) consent to serve as a teen volunteer at Advocate Christ Medical Center.
I (we) have read the application/agreement and will share in the responsibility of this commitment.
I (we) also give my (our) consent for my (our) daughter/son to receive necessary TB (Mantoux) testing and the Influenza Vaccination.
PLEASE CALL EMPLOYEE HEALTH 708.684.5333 FOR ANY QUESTIONS OR CONCERNS.
NOTE: A COPY OF MMR AND VARICELLA IMMUNIZATIONS MUST BE PRESENTED AT TIME OF TB.