To parents/legal guardians
If you are not able to take your child to an appointment at CHOC, you may give permission for another adult to take your child to the appointment and make medical decisions for your child. You may give permission by completing the form called Authorization for Third Party to Consent to Treatment of Minor Lacking Capacity to Consent. This form lasts until you cancel it. Step‐parents do not have the legal right to make medical decisions for step‐children. If a step-parent will be bringing a step‐child to an appointment, it is important to have the Authorization for Third Party to Consent to Treatment of Minor Lacking Capacity to Consent signed by the biological parent/legal guardian.
These are the steps:
- Print out the Authorization for Third Party to Consent to Treatment of Minor Lacking Capacity to Consent
- Fill both sides of the form
- The “Name of Agent” is the name of the person you are giving permission to bring your child to the CHOC appointment
- Keep a copy for yourself
- Give the original to the person who will be bringing your child to the appointment
- For your child’s safety, we will ask for the person’s driver’s license or photo ID so we can confirm their identity
Frequently Asked Questions
- What is a legal guardian? A legal guardian is a person who has the right to make decisions for the child. The guardian is usually appointed by local law or court order, or by a deceased parent’s will.
- Can I hand write a note instead? It is best to use the Authorization for Third Party to Consent to Treatment of Minor Lacking Capacity to Consent.
A letter with the same information as the Authorization for Third Party to Consent to Treatment of Minor Lacking Capacity to Consent may be used but will need further review. Any documents from out-of-state or out‐of‐country will need further review. In these cases, CHOC will call the parent or legal guardian to get permission before giving care. This could delay the appointment, or the appointment may need to be rescheduled.
