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Submitted Consent Forms

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Student Name:
School
Class
Date of Birth
Eligible
To Be Treated
Treatment Date
Paying?
Treatment Done
Date Submitted

Name: Daisy Petersen

School: Rye Primary School
Class:1/2A
Date of Birth:12/07/2019
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:30/04/2026

Name: Ivie Petersen

School: Rye Primary School
Class:2B
Date of Birth:15/03/2018
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:30/04/2026

Name: Harriet Farr

School: Rye Primary School
Class:C
Date of Birth:15/04/2019
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:30/04/2026

Name: Eden Cusack

School: Rye Primary School
Class:1 C
Date of Birth:14/05/2019
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:30/04/2026

Name: Jimmy keanu Veenstra

School: Rye Primary School
Class:B
Date of Birth:30/09/2019
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:30/04/2026

Name: Kai Marshall

School: Rye Primary School
Class:C
Date of Birth:16/02/2018
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:30/04/2026

Name: Winter Johnson

School: Rye Primary School
Class:2C
Date of Birth:01/05/2018
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:30/04/2026

Name: Marsha Canedo

School: Rye Primary School
Class:B
Date of Birth:03/12/2014
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:30/04/2026

Name: Zoe Zhang

School: Rye Primary School
Class:1B
Date of Birth:21/09/2019
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:30/04/2026

Name: Willow Brooks

School: Rye Primary School
Class:A
Date of Birth:09/11/2015
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:30/04/2026

Name: Brodie Stephenson

School: St Augustine's Primary School
Class:5B
Date of Birth:04/05/2015
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:30/04/2026

Name: Billy Jarvis

School: Rye Primary School
Class:b
Date of Birth:24/12/2015
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:30/04/2026

Name: OWEN PHILLIPS

School: Rye Primary School
Class:PREP B
Date of Birth:18/11/2020
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:30/04/2026

Name: Baden Taube

School: St Augustine's Primary School
Class:UW
Date of Birth:06/01/2020
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:30/04/2026

Name: Eliza Galea

School: St Augustine's Primary School
Class:Prep K
Date of Birth:07/05/2026
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:30/04/2026

Name: Walter Plunkett

School: St Augustine's Primary School
Class:Prep V
Date of Birth:30/06/2020
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:29/04/2026

Name: Bondi Mason

School: St Augustine's Primary School
Class:B
Date of Birth:16/01/2018
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:29/04/2026

Name: Bruce Mason

School: St Augustine's Primary School
Class:P
Date of Birth:31/03/2016
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:29/04/2026

Name: Jordan Ross

School: St Augustine's Primary School
Class:W
Date of Birth:10/09/2016
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:29/04/2026

Name: MANXIN XUE

School: Northside Christian College
Class:M
Date of Birth:30/03/2015
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:29/04/2026