Kwänlin
Whitehorse
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Takhini River
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Dä̀kwä̀kä̀da
Haines Junction
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Lu ghä
Klukshu
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Consent for Release of Health Information
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Prenatal Consent for Release of Health Information
For the following purpose:
So there can be a linkage to between CAFN
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Please indicate any others that may advocate your health status on your behalf? (spouse, family members)
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I hereby consent to release my health information about my birth to: Champagne and Aishihik First Nations Community Wellness staff
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