Medical Consent Form

Protecting your children while you travel means more than getting a sitter or family relative to watch them. To be absolutely safe, you should provide written authorization for a responsible adult to approve any necessary emergency medical treatment for your children. The same holds true when your children travel without you.
Unless a child’s injuries are life-threatening, hospital personnel and physicians cannot treat him or her without legal parental or guardian consent. As a result your child may suffer unnecessary discomfort while waiting for you to be reached to approve stitching a cut or setting a broken arm.
Each time you or your child goes out of town without one another, complete the form below and provide the information requested on the back. A separate dated consent form is necessary each time you leave town. Please ask the adult you have designated on the consent form to keep it handy. It should be taken to the hospital or doctor’s office if a child requires medical treatment.
Medical Consent/English (PDF)
Formulario de Consentimiento Médico (PDF)
If you would like us to mail you copies of the form, just call us!