MoonRise Therapeutics Emergency Medical Treatment Authorization

Emergency Medical Treatment Consent Plan

In the event emergency medical aid/treatment is required due to illness or injury while being on the property at MoonRise Farm I authorize MoonRise Therapeutics staff or volunteers to secure and retain medical treatment and transportation if needed. This authorization includes x-rays, surgery, hospitalization, medication and any treatment procedure deemed “ life saving” by the physician.

Emergency Medical Treatment Non-Consent Plan

Parent or legal guardian will remain on site at all times during the process of receiving services or while being on the property of the agency. I do not give my consent for emergency medical treatment/aid in the case of illness or injury.