Minor Child Medical Consent Form PDF

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Minor Medical Consent Template PDF Free Download

Minor Medical Consent

The medical consent for the treatment of a minor is a simple but important document that grants authority to a designated adult to care for the child of the signatory in the case of a medical emergency.

The authority is temporary, the start and end date will be provided within the document.

As it is not always possible or practical to contact the parents or legal guardians of a child when there is a medical emergency, this document allows the designated adult to provide minor first aid and seek emergency treatment as they deem necessary.

When is it Needed?

A child medical consent form should be utilized when:

A parent or legal guardian would like to provide another entity or individual limited consent to obtain medical care for your child.

A parent or legal guardian would like to provide another entity or individual the ability to request medical attention for the child while under their care (i.e., babysitter, daycare).

The child will be in the temporary care of another individual or group (i.e., school teachers, church groups).

How to Write

Step 1 – Find a Competent Guardian

Utilizing a medical consent form for a child requires a fully competent individual.

It will be imperative that the individual has the character and capability to understand the scope and capacity of the consent.

This may require the guardian being available at all times in the chance they are needed to represent the best interests of the child.

Step 2 – Inform the Guardian of Child’s Medical Issues (if any)

When requesting an individual to be a guardian, it will be ideal for them to fully understand the child’s medical history.

Therefore, the parent(s) should ensure the child has had a recent appointment to certify that all vaccinations, allergies, medical history, surgery, current medications, health issues and/or concerns are up to date.

Step 3 – Inform the Guardian of the Child’s Medications

If there are any current prescriptions or medications that the child is on this should be included when reporting the child’s medical history to the guardian.

Especially if the guardian is expected to oversee the child’s medical intake.

Step 4 – Determine an End Date

In most States, it is required that there is an end date to a child medical consent (usually 6 to 12 months).

Otherwise, the hospital or medical facility may consider the guardianship invalid as permanent or recurring consent is required to be approved by a local court.

State Laws – A child’s medical consent falls under the jurisdiction of power of attorney.

Step 5 – Sign the Document

The form is highly recommended to be authorized by the parent and a witness in the presence of a notary public.

In the chance, this is not possible a third (3rd) party witness may be suitable, although, it is not guaranteed that it will be accepted by the healthcare facility.

Language English
No. of Pages1
PDF Size1 MB

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Minor Medical Consent Template PDF Free Download

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