MA Caregiver Authorization Affidavit free printable template

CAREGIVER AUTHORIZATION AFFIDAVIT Massachusetts General Laws Chapter 201F 1. AUTHORIZING PARTY (Parent/Guardian) I, residing at am: (circle one) the parent legal guardian legal custodian of the minor

AUTHORIZING PARTY (Parent/Guardian) II, residing at am: The minor child(men) listed in this application may be: (circle two) in the custody or control of any other person, who the minor child(men) parent(s) authorized to control the parent(s) under the Massachusetts Parental Guardianship Act, Chapter 2, §13; (circle three) a dependent spouse; and (circle four) a relative, and/or a dependent child(men). All other relationships referred to herein are prohibited, and I have read and understand the legal restrictions. I understand the parent(2/3) and legal guardian(3/4) have not consented to the use, or the exercise of any right or privilege, by the representative(s), unless specifically designated by me on this Application Form. 3. PARENT/GUARDIAN AUTHORIZATION AFFIDAVIT Massachusetts General Laws Chapter 201F PARENT/GUARDIAN AUTHORIZATION 1. A. The parent legal guardian of a minor child(men) or the parent guardian shall obtain the written authorization described above for the minor child(men) at least 48 hours before a meeting of the parent and/or legal guardian with either legal guardian. The parent legal guardian shall, within 48 hours after the receipt of the written authorization, contact a legal representative of the minor child(men), who shall then obtain the consent of the parent legal guardian and make the necessary arrangements from the custodial parent. This authorization shall apply to any meeting of the parent and/or legal guardian with either legal guardian after the date of this Application Form and shall be in addition to any other written authorization the minor child's legal representative may have obtained and executed. B. For all other conditions described in A above, the legal representative of the minor child(men) shall first obtain the written authorization of the mother. 2. ABOVE I have been granted Parent/Guardian Authorization A for the adult. I do hereby authorize, residing at and designated in the above manner by the adult(s), to be in charge of the adult, to exercise concurrently all rights and responsibilities, except those prohibited, that I might have if I was not the legal guardian of the adult. 3. OTHER PARENT/GUARDIAN AUTHORIZATION AFFIDAVIT Massachusetts General Laws Chapter 201F, Section 6C PARENT/GUARDIAN AUTHORIZATION 1.

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How long did you say it takes to get guardianship again about two months that's too long I need to get Lucy enrolled in school and take her to the doctor, so I can get her enrolled can I get something before the two months if there was an emergency like a danger to Lucy safety you could ask the court for a temporary guardianship to last until the hearing on your guardianship but for doctors visit or school enrollment you probably only need the caregivers' authorization affidavit I think I saw that in the courts form packet that's the first form with blanks to fill in the courts' packet right how am I going to get the parents to sign this you're correct that is the first form in the packet, but it doesn't need to be signed by the parents the caregivers' authorization affidavit is a declaration in which you state that your Lucy's relative you're caring for Lucy and that you've notified the parent of your intentions or could not find her parents it's then signed under penalty of perjury by you not the parents and this will allow me to enroll Lucy in school probably doctors may rely on this form to get authorization to perform treatment and schools may rely on this to establish residency in the school district can I use it to add Lucy on to my insurance probably not insurance policies benefits and numerous other things will probably require guardianship the caregivers' authorization affidavit isn't a court order and could be revoked by the parents at any time well I will need one of these where do I file it the caregivers' authorization affidavit is not filed with the court you present an original to any doctor or school that needs it oftentimes hospitals will carry their own version of this document in any event having one on hand never hurts, and you may end up needing several so be sure to keep an extra copy on hand since it's likely you'll need this let's fill this out what is Lucy's full name Lucy dawn Johnson that's D an IN yes the form itself is pretty self-explanatory I'm just writing Lucy's name on to line one where it says name of minor and what is Lucy's birthdate July 17, 2014, ok I'm typing that on to line two then your name on line three what is your address 321 Pinewood circles Sacramento California 958 14 I'll go ahead and fill that in on line 4 I'm checking the box on line 5 to indicate that you're qualified relative since you're a grandparent what's qualified relative as it says on the second page of the affidavit a qualified relative in this case is a spouse parent stepparent brother sister step-brother step-sister half-brother half-sister uncle aunt niece nephew first cousin or any of these with the word great or grand in front of them as well as the spouse of these even if the marriage ended with divorce or death of the biological relative as you can see it's a broad category spouse I can't see how that would apply it's because any of these relatives may marry and even the minor may be married because in California it's possible...

People Also Ask about ma caregiver authorization affidavit

What is the family code section 6552?

This section of law requires the caregiver to notify the provider of health care if the minor is no longer living with that caregiver. The caregiver authorization affidavit must be constructed so that it is substantially in the form provided in Family Code Section 6552.

What is the family code 6550?

Cal Fam Code § 6550 A caregiver who is a relative and who completes items 1-8 of the affidavit provided in Section 6552 and signs the affidavit shall have the same rights to authorize medical care and dental care for the minor that are given to guardians under Section 2353 of the Probate Code.

What is a caregiver signature?

Definition of a Caregiver Affidavit A caregiver affidavit is a legal document that allows a person (other than one's next-of-kin or power of attorney) to have the authority to act as a substitute decision maker for matters of health care for someone who is unable to do so.

What is California Family Code Section 6552?

This section of law requires the caregiver to notify the provider of health care if the minor is no longer living with that caregiver. The caregiver authorization affidavit must be constructed so that it is substantially in the form provided in Family Code Section 6552.

What is a caregiver affidavit California?

A Caregiver's Authorization Affidavit is a form you fill out and give to a child's school or health care provider. You can use the form to enroll the child in school or get medical care for the child. California law says what exactly should be in the form. California law also says who can use this form.

What is California Family Code Section 6550 6552?

Cal Fam Code § 6550 A caregiver who is a relative and who completes items 1-8 of the affidavit provided in Section 6552 and signs the affidavit shall have the same rights to authorize medical care and dental care for the minor that are given to guardians under Section 2353 of the Probate Code.

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What is the purpose of ma caregiver authorization affidavit?

A Caregiver Authorization Affidavit is a legal document that allows a designated caregiver to make decisions on behalf of a child or other individual who is not capable of making those decisions for themselves. This document is used to provide legal authority to a caregiver to make health care decisions, manage financial affairs, and other important decisions for the care of the individual.

What information must be reported on ma caregiver authorization affidavit?

The information that must be reported on a Caregiver Authorization Affidavit includes the following: 1. The full legal name, date of birth, and address of the caregiver. 2. The full legal name, date of birth, and address of the person in need of care. 3. A description of the type of care that the caregiver is authorized to provide, such as medical care, personal care, or financial management. 4. The duration of the authorization. 5. The authority of the caregiver to make decisions on behalf of the person in need of care. 6. A statement that the caregiver will abide by all applicable laws and regulations. 7. A statement that the caregiver will keep confidential any information related to the person in need of care. 8. The signature of the caregiver and the signature of an authorized witness.

What is the penalty for the late filing of ma caregiver authorization affidavit?

The penalty for the late filing of a caregiver authorization affidavit varies by state. In some states, there may be a late fee applied or the caregiver may be required to reapply for authorization. In some cases, the caregiver may be subject to criminal penalties. It is important to contact the appropriate state or local agency to determine the exact penalty for late filing.

What is ma caregiver authorization affidavit?

A caregiver authorization affidavit is a legal document that grants authority to a designated caregiver to make decisions and provide care for a minor child when the child's parent or legal guardian is unavailable or unable to do so. The affidavit generally includes information about the child, the caregiver, and the parent or legal guardian granting the authorization. This document is usually used in situations where a parent needs to temporarily delegate their parental rights and responsibilities to a trusted caregiver, such as during extended periods of absence, illness, or deployment.

Who is required to file ma caregiver authorization affidavit?

As of my knowledge, only parents, legal guardians, or legal custodians of incapacitated or minor adults are required to file a Massachusetts Caregiver Authorization Affidavit. This affidavit allows non-parent caregivers to make important decisions regarding the child's education, healthcare, and other aspects. However, it is advisable to consult with a legal professional or refer to the relevant Massachusetts state laws to confirm the current requirements and specifics.

How to fill out ma caregiver authorization affidavit?

To fill out a caregiver authorization affidavit, follow these steps: 1. Begin by entering the county and state where the affidavit is being filed at the top left corner of the document. 2. Enter the full name of the child or children involved in the affidavit. Include their date of birth, and any other relevant details such as social security numbers, if applicable. 3. Identify the person who will be acting as the caregiver and make sure to include their full legal name, address, and contact information. 4. Specify the relationship between the caregiver and the child or children. This could be a parent, grandparent, legal guardian, or other legal relationship. 5. Indicate the full legal names of the parents or legal guardians of the child or children. Include their addresses and contact information. 6. If there are other legal parties involved, such as second legal guardians or non-custodial parents, provide their full legal names, addresses, and contact information. 7. Sign and date the affidavit at the bottom, indicating that the information provided is true and accurate to the best of your knowledge. 8. Have the affidavit notarized by a notary public. This step is crucial for the document to be considered legally binding. 9. Make copies of the completed, notarized affidavit for your records and for any parties involved. It is recommended to keep the original copy in a safe place. Remember, this information is general guidance, and the specific instructions and requirements for a caregiver authorization affidavit may vary depending on your jurisdiction. It is advisable to consult an attorney or legal professional for personalized assistance.

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