By typing and signing my name below and as the parent (or legal guardian) of my child, I give permission for my child to receive services at Lowell Community Health Center and at the health center's School-Based Health Centers located within Lowell Public Schools. I give permission for a designated health provider to deliver the services outlined here. I also consent to the exchange of health history, such as immunization records, with the school nurse and other appropriate providers in compliance with HIPAA regulations. The health record of students seen at the School-Based Health Center at Lowell Public Schools is a confidential record, and is not part of a school record. I understand that confidentiality will be observed due to the nature of this type of record, and that my child may withdraw this consent form in writing at any time during my child's enrollment in the Lowell Public Schools.