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Teen Health Center document downloads
The following are downloadable documents for Teen Health Center staff organized by school. Items are subject to change over time. To ensure you are viewing the latest information, press the Refresh or Reload button on your browser menu or the F5 key on your keyboard.
Consent to Bill and Treat, Acknowledgement of Receipt with translated Notice of Privacy Practices:
- Letter to parents informing them about services available to students at the Cleveland Teen Health Center:
- Microsoft Word (English)
- Microsoft Word (Spanish)
- Adobe PDF (English)
- Program Description/Disclosure, Participant Rights and Consent to Participate, Kaiser Permanente (MS Word)
- Client Registration Worksheet
- Spanish (MS Word)
- Russian (MS Word)
- Vietnamese (MS Word)
- Consent to Release of Education Records Under the Family Education Rights and Privacy Act (FERPA), (PDF)
COVID-19 resources
King County:
Washington State:
- Coronavirus - COVID-19 Updates, WA State Dept. of Children, Youth, and Families
- COVID-19-related information on childcare, schools, colleges, and universities, WA State Dept. of Health
- Novel Coronavirus (COVID-19) Guidance & Resources, WA Office of Superintendent of Public Instruction (OSPI)
Consent to Bill and Treat, Acknowledgement of Receipt with translated Notice of Privacy Practices: - English consent
- Notice of Privacy Practices
- Notice of Privacy Practices brochure (available in English only)
- Russian consent
- Spanish consent
- Vietnamese consent
- Letter to parents informing them about services available to students at the Ingraham Teen Health Center:
- Ingraham Teen Health Center patient registration form (English, PDF)
- Ingraham Teen Health Center patient registration form (Spanish, PDF)
- Consent to Release of Education Records Under the Family Education Rights and Privacy Act (FERPA), (PDF)
COVID-19 resources
King County:
Washington State:
- Coronavirus - COVID-19 Updates, WA State Dept. of Children, Youth, and Families
- COVID-19-related information on childcare, schools, colleges, and universities, WA State Dept. of Health
- Novel Coronavirus (COVID-19) Guidance & Resources, WA Office of Superintendent of Public Instruction (OSPI)
Letter to parents informing them about services available to students at the Rainier Beach Teen Health Center:
- Microsoft Word (English)
- Microsoft Word (Spanish)
- Adobe PDF
- Program Description/Disclosure, Participant Rights and Consent to Participate, Kaiser Permanente
Consent to Bill and Treat, Acknowledgement of Receipt with translated Notice of Privacy Practices:
Client Registration
Consent to Release of Education Records Under the Family Education Rights and Privacy Act (FERPA)
COVID-19 resources
King County:
Washington State:
- Coronavirus - COVID-19 Updates, WA State Dept. of Children, Youth, and Families
- COVID-19-related information on childcare, schools, colleges, and universities, WA State Dept. of Health
- Novel Coronavirus (COVID-19) Guidance & Resources, WA Office of Superintendent of Public Instruction (OSPI)