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    WAIVER PARENTS CONSENT FORM For RLE Exposure

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    Geylla Faeldonia
    This document is a parent waiver and consent form for nursing students at PHINMA University of Iloilo who will participate in related learning experiences in the community and hospital setting during the second semester of the 2023-2024 academic year. It informs parents of the required activities outside of the classroom and asks for permission and a waiver of liability should any incidents occur during their child's participation. Parents provide their signatures to grant consent and waive rights to file charges against the university or cooperating organizations in the case of an untoward event.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    WAIVER PARENTS CONSENT FORM For RLE Exposure

    Uploaded by

    Geylla Faeldonia
    119 views1 page
    This document is a parent waiver and consent form for nursing students at PHINMA University of Iloilo who will participate in related learning experiences in the community and hospital setting during the second semester of the 2023-2024 academic year. It informs parents of the required activities outside of the classroom and asks for permission and a waiver of liability should any incidents occur during their child's participation. Parents provide their signatures to grant consent and waive rights to file charges against the university or cooperating organizations in the case of an untoward event.

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    WAIVER-PARENTS-CONSENT-FORM-for-RLE-Exposure

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    This document is a parent waiver and consent form for nursing students at PHINMA University of Iloilo who will participate in related learning experiences in the community and hospital setting during the second semester of the 2023-2024 academic year. It informs parents of the required activities outside of the classroom and asks for permission and a waiver of liability should any incidents occur during their child's participation. Parents provide their signatures to grant consent and waive rights to file charges against the university or cooperating organizations in the case of an untoward event.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    119 views1 page

    WAIVER PARENTS CONSENT FORM For RLE Exposure

    Uploaded by

    Geylla Faeldonia
    This document is a parent waiver and consent form for nursing students at PHINMA University of Iloilo who will participate in related learning experiences in the community and hospital setting during the second semester of the 2023-2024 academic year. It informs parents of the required activities outside of the classroom and asks for permission and a waiver of liability should any incidents occur during their child's participation. Parents provide their signatures to grant consent and waive rights to file charges against the university or cooperating organizations in the case of an untoward event.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    College of Allied Health Sciences

    Nursing Department
    Rizal Street, Iloilo City

    LEVEL II – PARENT’S WAIVER & CONSENT FORM


    (FOR RELATED LEARNING EXPERIENCE IN THE COMMUNITY (HOME VISIT) AND HOSPITAL EXPOSURE)
    2ND Semester, A.Y. 2023-2024

    DEAR PARENTS:

    Greetings!

    As a requirement of your child’s course, the College of Allied Health Sciences (NURSING DEPARTMENT), PHINMA
    University of Iloilo would like to inform you that your son/daughter, _____________________________________________,
    of BSN _________________ will be exposed to the hospital & community for the subject NUR 193 Community Health
    Nursing RLE and NUR 146 Care of Mother & Child at Risk or with Problems RLE, this 2nd semester, 2023-2024.

    Respectfully yours,

    MA. DOIE D. DELARIMAN, RN, MAN


    Clinical Coordinator, LEVEL II

    Noted:

    JOHN REY S. OLPOC, RN, MN


    Dean, College of Allied Health Sciences

    PARENT’S PERMISSION AND WAIVER FOR AFFILIATION


    WE, ____________________________________________, and _______________________________________,
    both of legal age, Filipino and residents of _________________________________________________________, hereby
    depose and say:

    That we, are the parents of ______________________________________________, a _____________ year


    Bachelor of Science in Nursing student of PHINMA University of Iloilo;

    That as a requirement of his/her course, we are permitting our child to go on duty for the related learning
    experience (Hospital and Community) for the 2nd semester, AY 2023-2024.

    That we realize the risk in connection with our child’s duty, we hereby waive our rights to file any charges against
    PHINMA University of Iloilo or any of its officers and directors or any of its faculty members, the hospital and/or any of its
    employees and will absolve the foregoing from any liability or claim whatsoever should any untoward incident happen in the
    course of his/her duty.

    IN WITNESS WHEREOF, we have here unto set our hands this ____________ day of _________ in the City of
    Iloilo, Philippines.

    _________________________________________ ___________________________________________
    Signature over Printed Name of Father/Guardian Signature over Printed Name of Mother/Guardian

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