Child Medical Consent Form

Child Medical Consent Form

What Is a Child Medical Consent Form?

When parents are in the process of hiring a babysitter or daycare center to help care for their children it is important that they complete a Child Medical Consent Form on behalf of the party who will be watching the child.

Alternate Names:

  • Medical Consent Form for Minor;
  • Minor Medical Consent Form.

Having this type of form will provide the guardian with the necessary information to contact a medical professional that will know the child's medical history. A free printable Child Medical Consent Form can be downloaded below. This form can be part of a Child Care Contract or Nanny Contract and allows a person or party who is not a legal guardian or parent to seek medical assistance in case of an emergency on behalf of the child.

Additionally, you can also have a third-party caregiver complete a Child Travel Consent Form if they will be expected to frequently travel with your child while you are not present. And any expenses they may incur while caring for the child can be recorded in a Child Care Receipt.


How to Give Medical Consent for a Child?

Make sure to include the following information to create a Child Medical Consent Form:

  1. Begin by stating that you - as the parent of the child - grant the ability to determine Child Medical Consent by [The Third Party Person or Daycare] while the child is under their care. Include what medical care you agree to give the third party consent over. State that any medical treatment must also be deemed necessary by a physician or medical professional; If there are any specific topics (such as the right to Do Not Resuscitate) that you do not approve of the caretaker to be in charge of, make sure this is stated as well.
  2. Provide the contact information and mailing address where the third party is located.
  3. Provide the contact information and mailing address of you and your partner in case an emergency should arise. This will allow a physician to contact you immediately in case an emergency should arise.
  4. Include a list of the child's vaccination records, allergies (such as food, drugs, or animals), and any additional medical details. If the child will need to have emergency medicine available to them at all times include the name of the drug, how it should be administered, and who to contact to alert the parents or the child's primary physician. If the child is old enough to administer the drug themselves, include this information and what the caregiver should do once the child has taken the drug.
  5. Provide the name, contact information, insurance information, and preferred hospital of the child's physician. If this permission is temporary, include the date that this contract will be terminated.
  6. Provide a signature section for yourself, the guardian, and a third witness with date sections. Be sure to provide a copy for each person signing the document and maintain at least two copies for yourself for record-keeping.

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Download Child Medical Consent Form

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