Free Child Medical Consent Form

You may need a child’s medical consent form​ any time your child is in someone else’s care. For example, it often comes up when they are:

• Staying with grandparents or other relatives
• Spending time with a babysitter or nanny
• Going away to camp
• Traveling for a school trip or extracurricular activity

Doctors usually need a parent’s permission before treating a child, and without written consent, care may be delayed until a parent or guardian can be reached.

That delay can be risky if urgent treatment is needed. A child’s medical consent form helps avoid those issues and supports both emergencies and routine care, such as:

• Accidents or sudden illness that require urgent attention
• Routine doctor visits or prescriptions that keep care consistent

Having a child’s medical consent form​ in place keeps everyone on the same page during stressful moments. It’s a simple step that makes care easier for both families and providers.

Child medical consent laws differ by state. In most cases, parents or guardians must approve a child’s medical care. Some states make exceptions, allowing minors to consent on their own for things like pregnancy care, treatment for STDs, substance use, or other urgent health needs.

Because the rules differ, what applies in one state may not apply in another. Parents and caregivers should check local laws before relying on a consent form. Here’s a state-by-state breakdown showing when minors can legally consent to routine and public health care:

A good child medical consent form ​makes sure your child’s care is in safe hands. It protects your child’s health no matter the circumstance. Here’s what to include:

• Start with your child’s information, including full name, date of birth, and address.
• Add parent or guardian details, such as names, phone numbers, addresses, custody information if relevant, and signatures.
• List the caregiver’s information, including name, relationship to the child, phone number, and address.
• Provide health details, such as allergies, chronic conditions, current medications, and vaccination history if relevant.
• Include the doctor and emergency contacts, noting the child’s physician, preferred hospital or clinic, and an alternate emergency contact.
• Add insurance information, including provider name, policy number, and group number.
• Define the scope of consent, outlining which treatments the caregiver can approve (emergency and routine) and any that are not allowed.
• Clarify access rights, stating whether the caregiver can see records and claims or only speak with doctors. If you want providers to share records with the caregiver, attach amedical records release (HIPAA) form.
• Note any special instructions, like dietary restrictions, religious considerations, or pharmacy preferences.
• Set clear dates of authority, with a start and end date. If no end date is given, the form remains valid until revoked.
• Allow for multiple caregivers if parents want to share authority between more than one adult.
• Add a revocation clause, confirming parents can revoke consent in writing at any time.

For convenience, Legal Templates offers a free printable medical consent form for a minor. Just download, fill it out, and be ready if care is needed.

A child’s medical consent form doesn’t always need to be notarized. Most of the time, a parent’s signature is enough. Still, notarization adds extra weight and can make things smoother in certain situations:

• Non-emergencies: Helps confirm the signature and avoid hold-ups with treatment.
• International travel: Carries more legal weight at borders, airlines, or foreign hospitals.
• Specific facilities: Some camps, schools, or hospitals require it as part of their rules.

Here’s a sample medical consent form for a minor you can use as a reference. If you’d like something ready to fill out, Legal Templates offers a customizable version in both PDF and Word. You can download it today to make sure your child’s care is covered.