Medical consent for a child who is in a grandparent’s, relative’s or nanny’s care

When this helps, and what the law we read says

Who may consent to a child’s treatment when no parent is there depends on the state, and we read six: Texas, California, Florida, New York, Illinois and Arizona. Texas lets a grandparent, an adult brother or sister or an adult aunt or uncle consent to a child’s medical, dental, psychological and surgical treatment when the person who has the right to consent cannot be contacted and has not given notice to the contrary. ^[1]

The same Texas section lets an adult who has actual care, control and possession of the child consent as well, if that adult has written authorization from a person who has the right to consent. ^[1] That is the case this document is built for: a caregiver who is not a grandparent or a sibling, or a clinic that wants the parents’ permission in writing.

California’s Family Code section 6910 says a parent or guardian may authorize in writing an adult into whose care a minor has been entrusted to consent to medical or dental care, or both, for the minor. ^[3] The four other states we read are described below. For any other state we did not review the rules, so check yours.

Notice what the Texas section does not say: it is written for situations where the parent cannot be contacted. A written authorization does not stop a clinic from trying to reach you, and this document asks that the parents be contacted as soon as possible.

This is also not the Texas authorization agreement for an adult caregiver. Chapter 34 of the Texas Family Code lets a parent authorize a caregiver to do much more than consent to treatment, including enrolling the child in school, obtaining health insurance, and applying for benefits, and it requires the parent and the caregiver to sign and swear to the agreement before a notary public. ^[2] Our document is much narrower: it covers medical care only, it excludes school enrollment, insurance and benefits, and it ends on a date you choose. If you need what chapter 34 describes, use that agreement, not this one.

Florida lets a stepparent, a grandparent, an adult brother or sister, or an adult aunt or uncle consent to a child’s ordinary medical and dental care when the parent cannot be reached after a reasonable attempt; the provider records the attempt and tells the parent afterwards. First in Florida’s order comes a person holding a power of attorney to provide medical consent for the child, and Florida’s definition of ordinary care leaves out surgery, general anesthesia and psychotropic medicines. ^[4] A Florida power of attorney must be signed before two witnesses and acknowledged before a notary public. ^[5] This document is not a power of attorney and has no witness lines, so it does not meet that Florida rule; in Florida it is the parents’ written consent and nothing more.

New York has a statutory designation of a person in parental relation: a parent may designate another adult for up to twelve months, and the designation can be shown to a school, a health care provider or a health plan. It must follow the form set out in the law, and a designation for more than 30 days must be notarized. ^{[6] [7]} This document is not that form. If a New York provider asks for the designation, use the statutory form.

Illinois lets a parent appoint a short-term guardian in writing without going to court, for 365 days unless the paper says otherwise. The parent signs in front of two adult witnesses who are not the person appointed, and if the other parent is available and able to decide, that parent must consent too. ^[8] That is a guardianship, far broader than a medical consent, and this document is not one.

Arizona lets a parent delegate powers over a child’s care, custody or property to another person by a properly executed power of attorney, for no more than six months. ^[9] This document is not a power of attorney and does not delegate parental powers. It can run up to 12 months, but in Arizona choosing an end date within six months keeps that limit from becoming a question.

We cannot tell you how a particular clinic, hospital or insurer will treat this document, and we do not claim that any of them accept it. Some may ask for their own form. Ask the clinic before you rely on any letter.

What the document includes

• An authorization from the parents or legal guardians naming the caregiver who may consent to the child’s medical care, and the start and end dates
• Your choice of scope: emergency care only, or emergency and routine care for ordinary illness and minor injuries, including the prescriptions and tests a physician orders for them
• A plain statement of what it does not cover: elective or non-urgent surgery, school enrollment, insurance or public benefits, and any other decision
• The caregiver’s name, relationship to the child, ID details and phone number
• Allergies, medical conditions and medications for each child (up to six), if you choose to enter them
• Insurance plan, policy or member number and the insurer’s phone, and the child’s regular doctor, if you choose to enter them
• A request that the parents be contacted as soon as possible if the child needs care, and a line saying the authorization ends earlier if the parents tell the caregiver in writing
• A signature block for each parent, and a blank area for a notary public’s acknowledgment that is clearly marked optional
• English and Spanish side by side on every page, on U.S. Letter paper

How it works

1. Enter the parents, the caregiver, the children’s health details and the dates. The period can run up to 12 months from the start date. Leave the optional sections empty if they do not apply.
2. Check the free, watermarked preview. Nothing is stored to make it.
3. Pay once ($9, no subscription) and download the PDF.
4. Print it. Each parent signs. Notarizing is your choice: the Texas and California sections we read ask for a written authorization and do not mention a notary. New York’s statutory designation for more than 30 days must be notarized, and Florida’s power of attorney needs a notary and two witnesses, so read the state notes above.
5. Give the original to the caregiver, keep a copy, and give the clinic a copy before it is needed. Ask the clinic what else it wants.

Is there a free official form?

Some states publish a statutory form for authorizing a caregiver. Texas has the chapter 34 agreement described above, which is broader than this document and has to be sworn before a notary public. ^[2] California’s section 6910 refers to the caregiver’s authorization under section 6550, a form we could not open and therefore say nothing else about. ^[3]

New York’s law contains the text of its designation form, which is free to copy. ^[7] The Illinois short-term guardian section also includes a form, which it says is optional. ^[8] Both are broader than this document and have their own signing rules.

A pediatrician’s office, a school, a camp or an insurer may also have its own medical consent form, and where one exists you are free to use it instead. This document is for the common case where no form applies and a clear, signed page is what the family needs.

Frequently asked questions