• Consent To Treat a Minor

    Consent To Treat a Minor

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    The following form is designed for those situations where minors are  unaccompanied by either parents or legal guardians. This "Parental Consent to Treat A Minor Form" gives authority to a designated adult to arrange for

    Medical care cannot be provided to a minor without the approval by the parents or legal guardians, unless there is written consent authorizing an agent to give approval. In addition, a copy of the Parent/Legal Guardian photo ID must be provided with consent.

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  • I   *  *, am the Parent/Legal Guardian of the child listed below and there are no court orders now in effect that would prohibit me from conferring the power to consent upon another person.

    I authorize   *   * to provide the following:   

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