PARENTAL CONSENT TO TREAT A MINOR FORM
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 for a minor. 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.