Consent for the Provision of Intimate Care

During the course of your child’s time at St Andrew’s, staff may have to provide intimate care for your child.

This form is valid from the date of signing until your child has left the setting. Please note that you have the right to withdraw or change your consent at any time by giving the school written notice and completing a new consent form.

 

Please complete all fields marked (*)

Your first name *

Your last name *

I give permission for the provision of intimate care *

eg changing soiled clothing, washing and toileting

Yes No

I will advise the Head Teacher of any medical complaint my child may have which affects issues of intimate care *

Yes No

What is the full name of your child?

Which year did your child start school

Please provide a signature. *