Lic 627 Form PDF Details

Are you looking for a way to make your business more efficient? If so, you may want to consider using the Lic 627 form. This form is used to apply for a license to conduct business in Louisiana. By using this form, you can streamline the process of starting or running your business. In this blog post, we will discuss the basics of the Lic 627 form and how it can benefit your business.

Below is the details concerning the PDF you were seeking to fill in. It can tell you the span of time you will need to finish lic 627 form, what parts you will need to fill in, and so on.

QuestionAnswer
Form NameLic 627 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other nameslic627b, lic627 form, california 627 form, ca lic 627 form

Form Preview Example

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

CONSENT FOR EMERGENCY MEDICAL TREATMENT-

Child Care Centers Or Family Child Care Homes

AS THE PARENT OR AUTHORIZED REPRESENTATIVE, I HEREBY GIVE CONSENT TO

_________________________________________ TO OBTAIN ALL EMERGENCY MEDICAL OR DENTAL CARE

FACILITY NAME

PRESCRIBED BY A DULY LICENSED PHYSICIAN (M.D.) OSTEOPATH (D.O.) OR DENTIST (D.D.S.) FOR

__________________________________________________ . THIS CARE MAY BE GIVEN UNDER

NAME

WHATEVER CONDITIONS ARE NECESSARY TO PRESERVE THE LIFE, LIMB OR WELL BEING OF THE CHILD

NAMED ABOVE.

CHILD HAS THE FOLLOWING MEDICATION ALLERGIES:

DATE

PARENT OR AUTHORIZED REPRESENTATIVE SIGNATURE

HOME ADDRESS

HOME PHONE

( )

WORK PHONE

( )

LIC 627 (9/08) (CONFIDENTIAL)

Watch Lic 627 Form Video Instruction

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