If your child is in government school DO NOT SIGN THIS FORM. Every State has a form like this. If there is no form submit your own letter as stated below.

In addition to not signing this form you need to file a letter with the district and your local school specifically stating YOU DO NOT AUTHORIZE the school or it's personnel to facilitate or perform ANY medical or mental health functions to your child.

If they freak out and say that this will prevent them from helping your child in a medical emergency explain to them that YOU KNOW THAT IS NOT TRUE. Through Good Samaritan Laws persons and Emergency Medical Professionals are always authorized to perform EMERGENCY care.

DO NOT CONSENT to blanket medical and psychological care.
This could save your child's life. LibertyFirst.Legal