This version of the form is not currently in use and is provided for reference only. Download this version of Form CY867 for the current year.
This is a legal form that was released by the Pennsylvania Department of Human Services - a government authority operating within Pennsylvania. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is the purpose of the CY867 Emergency Contact Parental Consent Form?
A: The CY867 Emergency Contact Parental Consent Form is used to authorize emergency medical treatment and provide contact information for a child in Pennsylvania.
Q: Who needs to fill out the CY867 form?
A: This form should be filled out by the parent or legal guardian of a child residing in Pennsylvania.
Q: Is the CY867 form mandatory?
A: Yes, it is mandatory for parents or legal guardians to complete the CY867 form for their child in Pennsylvania.
Q: What information is required on the CY867 form?
A: The CY867 form requires information such as the child's personal details, emergency contact information, and consent for emergency medical treatment.
Download a fillable version of Form CY867 by clicking the link below or browse more documents and templates provided by the Pennsylvania Department of Human Services.