ANASAZI Foundation

MEDICAL FORMS

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Please download, print, and fill out the forms in the following link. Once completed, please upload them through THE DAWNSTAR APP.

MEDICAL FORMS

The forms in the above link include:

  • Consent for Emergency Medical Treatment
  • Consent for Release of Confidential Medical Information
  • Important Medication Notice (Medications Supplied On The Trail)
  • Informed Consent for Prescribed Medications

The following form is needed for EACH person on Admission Day (including client AND family members dropping off client):

  • Consent for Emergency Medical Treatment

Also use THE DAWNSTAR app to upload the paperwork listed below. **PLEASE NOTE** Physicals and bloodwork MUST be completed 2 weeks before Admission Day.

  • Immunization Record
  • Blood Work/ Lab Work