Release of Medical Information Leave this field blank Release of Medical Information I, (parent or guardian name) give (Doctor's office name) permission to send medical information to. Grandma's Kids Childcare Center 4220 Orphanage Road Concord, NC 28027 Phone: (704) 7921668 Fax: (704) 7921668 On the following child(ren): Name: Date of Birth Parent or Guardian Signature Start drawing Clear Done Start over Date Submit A place where children grow, learn and thrive. Let's team up together! Inquire Now!
