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EHS TUPE Referral (English and Spanish
Tobacco-Use Prevention Education
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EHS Consent Form
Dear Parent,
Please sign and return this consent form to the main office or the Wellness Center. This consent form will
ensure that your child receives the services he/she/they might need from the Edison High School Wellness
Center. All services are free of charge. A separate permission slip will be sent home if your child needs a sports
physical. If you have any questions, please feel free to contact Sophia Cardona, Wellness Center Coordinator,
at 209/933-7425 ext. 8092.