Consent for Treatment of a Minor

I/We, as guardian(s), consent to the treatment of my child by The Hope Company, LLC. I am aware that I will be requested to participate in the treatment of my child to include, but not limited to, the developing of their individual treatment plan and regular meeting. I am aware that I have the right to, at any time, ask questions concerning their treatment, while having an understanding that confidentiality also applies(required) Yes I give my consent

No I do not give my consent

Child's name(required)

Guardian's name(required)

Guardian's phone(required)

Guardian's email