I certify that I have legal authority to consent to medical treatment for the child named above, including the administration of medication at the facility. I. There is no cost to families for your Early Intervention services.You may also download and print the forms from this website, fill them out ahead of time, and bring them with you to the first appointment. Using this form, you give permission to other adults to act for you, in your absence, regarding the treatment of your child. This is a legal document. To request the release of your medical information, fill out our Medical Record Release form.