Authorization For Consent To Medical Treatment For Minors printable pdf download

Authorization For Consent To Medical Treatment For Minors

CONSENT/AUTHORIZATION FOR TREATMENT OF MINORS

You are about to leave for a well-deserved vacation. Your best friends/parents

have agreed to watch your children while you are gone. Everything is packed, the

kids are excited to be staying with your friends/parents and you’ve left the

emergency numbers. But there is one important detail that you may have

forgotten….

During your absence, your child may suffer an illness or injury that requires

medical attention. To ensure that your child will get that attention as easily as

possible, you should complete an “Authorization for Consent to Medical Treatment

for Minors” form before you leave. This form gives the child's designated care taker

or non-parent family member the right to authorize treatment if the need arises. In

an emergency situation, your child would automatically be treated. Of course,

every reasonable effort would be made to contact you as soon as possible, but it

may prove to be difficult if you are not near a telephone or do not have cell phone

reception.

As a general rule, minors cannot consent to treatment. Therefore, except in special

situations, e.g., emergency treatment or emancipation, a physician must obtain

the consent of the parent(s) or legal guardian to treat a minor. In the case of a

medical emergency, when a child requires immediate treatment in order to save

his or her life or to prevent injury to health, treatment may proceed without

parental consent.

Please complete this form. That way we will know that you have authorized the

designated person to make medical decisions in your absence.

Authorization For Consent To Medical Treatment For Minors