Medical Care Authorization

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Medical Care for Children
Adult Children. Once your child is 18 years of age, you cease to have the right to authorize medical
treatment for your child. Thus, if your child was incapacitated in an accident, you would not automatically
be able to make medical decisions for your child. You should urge your children who are age 18 or over to
sign a Durable Power of Attorney for Health Care.
Minor Children. When you are out of town, and your minor children remain in town in the care of a
nanny, housekeeper, friend or relative, a child of yours may face an emergency medical situation. You may
be unreachable for an extended time. Of course, you should leave the name and telephone number of the
child's physician and dentist with the caretaker, so that they could be called in case of a medical
emergency. However, the physician or dentist cannot treat your child (other than certain emergency
procedures) without proper authorization, and the person with temporary custody of your child does not
automatically have the right to authorize medical treatment of your child. Fortunately, California law
allows a parent to sign a document to authorize another person having temporary custody of a minor child to
made medical decisions for the child. California Family Code Section 6910. For more information on
medical treatment of minors, visit the website of the
California Medical
Association.
The following form can be used to authorize your child's caregiver to act on your behalf:
MEDICAL CARE AUTHORIZATION
Pursuant to California Family Code §6910, I, ________________________________, a parent having legal custody
of _________________________________, a minor child, hereby authorize ____________________________, an
adult person into whose care such minor child has been entrusted, to consent to any X-ray examination (or similar
examination such as by CAT scan), anesthetic, medical or surgical diagnosis or treatment and hospital care to be
rendered to the minor under the general or special supervision and upon the advice of a physician and surgeon
licensed under the provisions of the Medical Practice Act or to consent to an X-ray examination, anesthetic, dental or
surgical diagnosis or treatment and hospital care to be rendered to the minor by a dentist licensed under the provisions
of the Dental Practice Act. I agree to pay any and all costs for the foregoing. My medical insurance provider is
________________________ and my insurance certificate number and/or group number is __________________.
Dated:_____________________
Signed:_____________________________

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