Child (Minor) Medical Consent Form

Use our child medical consent form to let someone make healthcare decisions for your child in your absence.

Child Medical Consent Form

Updated June 20, 2024
Written by Sara Hostelley | Reviewed by Brooke Davis

A child (minor) medical consent form allows another adult (besides a parent or legal guardian) to make healthcare decisions for someone under the legal age when their parents or guardians are unavailable. The legal age varies by state, but it’s commonly under 18.

What Is a Child Medical Consent Form?
Why Is It Important?
When Is It Necessary?
States Laws on Minor Consent
Steps to Granting Medical Consent for a Minor
How to Write a Child Medical Consent Form
Sample Child Medical Consent Form
Frequently Asked Questions

Supplementary Forms

If a parent or legal guardian is not traveling with their kid, they often pair a child medical consent form with a child travel consent form.

Furthermore, a minor (child) power of attorney lets them grant a trusted adult the authority to make broad decisions on a child’s behalf, potentially relating to their healthcare and education.

What Is a Child Medical Consent Form?

A child medical consent form is a written document authorizing a designated adult to make healthcare decisions for a minor child. As a parent, you may need a grandparent, aunt, uncle, family friend, nanny, babysitter, or daycare provider to care for your child at some point. If a medical emergency arises, it’s important these individuals have the authority to approve medical treatments.

According to the American Academy of Pediatrics, healthcare workers can only provide emergency care without parental consent if the child’s life is in danger [1] . So, you can execute a child medical consent form to get prompt medical treatment for your child without obstacles.

Ways to Give Consent

Written consent is preferable, as it gives advance notice that someone other than a child’s parent or legal guardian has authority over treatment and care authorization.

However, verbal consent may be given in emergencies when written consent isn’t feasible, and the child needs immediate treatment.

Why Is It Important?

Explore the importance of a child medical consent form by reviewing the benefits it offers:

It lets you designate a trusted individual. Electing a trusted individual to have authority over your child’s health care can give you peace of mind in case your child is involved in an accident or comes down with a sickness while you’re unavailable.
It reduces delays in care. If your child is experiencing an emergency and needs prompt treatment, a consent form lets a preselected person who may be in their presence make medical decisions on their behalf.
It ensures continuity and high-quality care. This form creates clarity surrounding your child’s health care, minimizing misunderstandings and providing healthcare professionals with clear instructions.

When Is It Necessary?

A child medical consent form is needed when a child’s parents or legal guardians aren’t readily available or present to give consent for medical treatment. Here are some actions a caregiver can complete when they have the consent that this form grants:

Obtain Medical Records: A parent/guardian may allow a caregiver to obtain a child’s medical records so they can make educated treatment plans if an emergency arises. Some healthcare providers may require a separate medical records release form so they can access previous health records.
Consent to Routine Evaluations and Treatments: This form can let a caregiver consent to routine evaluations and treatments, including routine vision and hearing tests, staple removal, or vaccinations.
Authorize Non-Routine Healthcare: This form can also give a trusted individual authority to make non-routine healthcare decisions that may involve experimental treatments, surgical interventions, and life support measures.

States Laws on Minor Consent

Review a list of state laws pertaining to medical consent for minors:

State	Child Consent Laws for Routine Medical Care	Child Consent Laws for Infectious Disease Treatment
Alabama	Ala. Code § 22-8-4	Ala. Code § 22-8-6
Alaska	Alaska Stat. § 25.20.025	Alaska Stat. § 25.20.025
Arizona	Ariz. Rev. Stat. § 44-132	Ariz. Rev. Stat. § 44-132.01
Arkansas	Ark. Code § 20-9-602	Ark. Code § 20-16-508
California	Cal. Fam. Code § 6922	Cal. Fam. Code § 6926
Colorado	Colo. Rev. Stat. § 13-22-103	Colo. Rev. Stat. § 25-4-409
Connecticut	Conn. Gen. Stat. § 19a-285	Conn. Gen. Stat. § 19a-216
Delaware	Del. Code tit. 13 § 707	Del. Code tit. 13 § 710
District of Columbia	D.C. Mun. Regs. tit. 22 § B600.1	D.C. Mun. Regs. tit. 22 § B600.7
Florida	Fla. Stat. § 743.067 and § 743.064	Fla. Stat. 384.30
Georgia	Ga. Code § 31-9-2	Ga. Code § 31-17-7
Hawaii	Haw. Rev. Stat. § 577D-2	Haw. Rev. Stat. § 577A-2
Idaho	Idaho Code § 39-4503	Idaho Code § 39-3801
Illinois	IL Stat. § 410.210/1	IL Stat. § 410.210/4
Indiana	Ind. Code § 16-36-1-3	Ind. Code § 16-36-1-3
Iowa	Iowa law requires medical professionals to have the consent of a parent or legal guardian before treating minors, unless it is a life threatening situation.	Iowa Code § 139A.35
Kansas	Kan. Stat. Ann. § 38-123B	Kan. Stat. Ann. § 38-123B
Kentucky	Ky. Rev. Stat. § 222.441	Ky. Rev. Stat. § 214.185
Louisiana	RS § 40:1079.1	RS § 40:1121.8
Maine	Me. Rev. Stat. § 22:1503	Me. Rev. Stat. § 32:3292
Maryland	Md. Code, Health-Gen. § 20-102	Md. Code, Health-Gen. § 20-102
Massachusetts	Mass. Gen. Laws § 112:12F	Mass. Gen. Laws § 112:12F
Michigan	Mich. Comp. Laws § 333.9132	Mich. Comp. Laws § 333.5127
Minnesota	Minn. Stat. § 144.341 and Minn. Stat. § 144.342	Minn. Stat. § 144.343
Mississippi	Miss. Code § 41-41-3	Miss. Code § 41-41-13
Missouri	Mo. Rev. Stat. § 431.056	Mo. Rev. Stat. § 431.061(4)(b)
Montana	Mont. Code § 41-1-402(1)	Mont. Code § 41-1-402(2)(c)
Nebraska	Neb. Rev. Stat. § 30-2604 and Neb. Rev. Stat. § 38-1232	Neb. Rev. Stat. § 71-504
Nevada	Nev. Rev. Stat. § 129.030	Nev. Rev. Stat. § 129.060
New Hampshire	NH Rev. Stat. § 318-B:12-a	NH Rev. Stat. § 141-C:18
New Jersey	NJ Stat. Ann. § 9:17A-1	NJ Stat. Ann. § 9:17A-4
New Mexico	NM Stat. § 24-7A-6.2	N.M. Stat. § 24-1-9
New York	NY Pub. Health Law § 2504	NYCCR Tit. 10 § 23.4
North Carolina	NC Gen. Stat. § 90-21.5	NC Gen. Stat. § 90-21.5
North Dakota	N.D. Cent. Code § 23-12-13	N.D. Century Code § 14-10-17
Ohio	Ohio Rev. Code § 2907.29, § 5122.04, and § 3719.012	Ohio Rev. Code § 3709.241
Oklahoma	Okla. Stat. tit. 63 § 2602	Okla. Stat. tit. 63 § 2602
Oregon	ORS § 109.640	Or. Admin. R. 333-003-5000
Pennsylvania	35 Pa. Stat. § 10104	28 PA Code § 27.97
Rhode Island	RI Gen. Laws § 23-4.6-1	RI Gen. Laws § 23-8-1.1
South Carolina	SC Code § 63-5-350	SC Code § 63-5-350
South Dakota	SD Codified Law § 20-9-4.2	SD Codified Law § 34-23-16
Tennessee	Tenn. Code § 63-6-229 and Caldwell v. Bechtol, 724 S.W.2d 739 (1987)	Tenn. Code § 68-10-104
Texas	Tex. Fam. Code § 32.003	Tex. Fam. Code § 32.003
Utah	Utah Code § 78B-3-406(6)	Utah Code § 26B-7-214
Vermont	Vt. Stat. Ann. tit. 18, § 4226	Vt. Stat. Ann. tit. 18, § 4226
Virginia	Va. Code § 54.1-2969(A)	Va. Code § 54.1-2969(E)
Washington	Wash. Rev. Code § 7.70.065, 26.28.020, and 13.64	Wash. Rev. Code § 70.24.110
West Virginia	Belcher v. Charleston Area Medical Ctr., 188 W. Va. 105, 422 S.E.2d 827 (W. Va. 1992), W. Va. Code § 49-4-115, § 60A-5-504, and § 16-29-1	W. Va. Code § 16-4-10
Wisconsin	Wis. Stat. § 51.13	Wis. Stat. § 252.11(4)
Wyoming	Wyo. Stat. §14-1-101	Wyo. Stat § 35-4-131
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Can a Child Consent to Their Own Medical Treatment?

A child living with their parents can’t usually consent to their own medical treatment until they reach the legal age. The legal age is usually between 18 and 21 in most states, but some states have a lower legal age. Some states may make exceptions if the child:

Shows adequate understanding of the treatment plan and associated risks.
Serves in the military.
Is married.
Lives apart from their parents.
Manages their own finances.
Can’t reach their legal guardians or parents.

Steps to Granting Medical Consent for a Minor

Follow these steps to grant medical consent for a minor:

Familiarize yourself with legal requirements. Learn the legal requirements in your jurisdiction, including the types of treatment that require parental authorization and who can provide consent in the parents’ absence.
Fill out the consent form. Specify your child’s personal information and your contact details.
Write the authorized procedures. Explain which procedures you’re allowing someone else to consent to on your child’s behalf.
Designate a caregiver. Name a person you trust as the person who can make decisions on your child’s behalf.
Read and sign. Review the document and sign.
Issue copies. Issue a copy to the authorized individual and retain one for yourself.
Inform healthcare providers. Distribute the form to healthcare providers who may need to know about the authorization, such as your child’s primary care provider.

How to Write a Child Medical Consent Form

Step 1 – Include the Child’s Information

Include the child’s full name, sex, date of birth, age, and address. The child is authorized by their parent or legal guardian to receive medical treatment when under the care of another person.

Step 2 – Fill in the Parent/Legal Guardian’s Information

The parent or legal guardian is the person who is giving consent for their child to receive medical treatment when they are not present. Include the guardian’s full name and contact information, such as their address and phone number.

Step 3 – Provide the Caregiver’s Information

Specify who will authorize medical treatment in the parents’ absence. Write the caregiver’s name and their relationship to the child.

Step 4 – Write Down Emergency Contact Information

Include the contact information for an emergency contact person the caregiver can contact if they can’t reach the child’s parent or legal guardian when the child is under their care.

Consider providing an alternative emergency contact person. This way, the caregiver will have a secondary option if the first emergency contact can’t help or doesn’t respond to a phone call.

Step 5 – Clarify the Medical Treatment

You can choose the range of medical care in your child’s treatment. You may authorize the caregiver to decide on specific types of medical care, such as:

Routine examinations and checkups
Emergency medical treatment
Emergency medical transportation
Diagnostic imaging (x-rays, CT scans, MRIs)
Medication administration
Anesthesia-induced surgical procedures

Include the start date of the medical authorization and consent. Express how long the consent is valid. You can end it on a specific date or leave it valid until you decide to revoke it.

Step 6 – Provide Health and Medical Care Information

This information can help medical and healthcare workers make quick and effective diagnoses and decisions. Include as much information as possible about your child’s medical history, such as their last tetanus shot, whether they have any known medical conditions or allergies, and if they’re taking any prescription medications.

Ensure to provide the following additional information to improve the chances of your child receiving timely medical attention:

The child’s primary doctor
The child’s primary dentist/orthodontist
Your preferred medical facility for the child’s treatment
Insurance company name and other insurance information

Step 7 – Sign the Document

You can include witness signatures or have the form notarized in front of a notary public when you want to sign the document.

The decision to include witnesses or notary acknowledgment on child medical consent forms varies by state. Check with your local or state law to ensure medical and healthcare professionals will recognize the form.

In certain states, you can seek online notarization. Check with a local notary to see if you can obtain remote online notarization and still have a valid, legally binding document.

Sample Child Medical Consent Form

Download a sample child medical consent form in PDF or Word format: