The pre-participation form must be completed and returned to our office. Parents/Guardians must complete page 1, and your doctor must review and complete page 2 and sign page 1 and 2.
Please fax the completed form to: (512) 406-6520, or mail to:
Dell Children's Medical Center of Central Texas
Senior Department Assistant
4900 Mueller Blvd.
Austin, Texas 78723
Once we have received the form, we will contact you to confirm participation. Please note that we have a limited number of spots in the program, so if the current session is full, we'll put you on the priority list for future sessions.