Consent of Child-Juvenile to Medical Services Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
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JD-1734A, 05/00 Consent of Child/Juvenile to Medical Services 24724748.373, 938.373 and 938.296(4), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE INTEREST OF Name Date of Birth Consent of Child/Juvenile to Medical Services Case No. I consent to the following medical services including surgical procedures when needed: DISTRIBUTION: 1. Court 2. T reatment F acility (certified or authenticated) Child /Juvenile /GAL Name Printed or Typed Date American LegalNet, Inc. www.FormsWorkFlow.com