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This form is used to obtain consent from a minor's parent or legal guardian for health-related services provided by the St. Cloud State University Student Health Services.

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How to fill out St. Cloud State University Student Health Services - Minor Consent to Treatment Form

1. Begin by reading the instructions on the form carefully.
2. Fill out the minor's name, date of birth, and other identifying information at the top of the form.
3. Provide the parent or guardian's name, address, and contact information in the specified section.
4. Indicate the specific types of treatment the minor may receive (e.g., medical exams, immunizations, counseling).
5. Sign and date the form in the designated areas to authorize consent.
6. If necessary, provide any additional information that may assist Health Services in treating the minor.
7. Submit the completed form to St. Cloud State University Student Health Services either in person or via their specified submission method.

Who needs St. Cloud State University Student Health Services - Minor Consent to Treatment Form?

1. Parents or guardians of minors who seek medical treatment or services at St. Cloud State University.
2. Minors who are not yet 18 years old and need consent from a parent or guardian to access health services.

People Also Ask about

What is informed consent for a minor?

Informed consent must include the patient being competent and understanding the options, risks, and benefits. For pediatric patients, parental consent, or consent from a surrogate, must be obtained for medical procedures, treatment, or research.

What is an example of consent for a child?

An example might be asking if it's okay to touch someone or be physically close to them. Someone gives consent when they know exactly what they are being asked to do, and they agree clearly, without being pressured.

What is an example of informed consent for a minor?

STATEMENT BY PERSON CONSENTING TO ALLOW THE MINOR'S PARTICIPATION IN THIS STUDY: I have read this informed consent document and the material contained in it has been explained to me verbally. All my questions have been answered, and I freely and voluntarily choose to consent to my child's participation in this study.

What is a sample letter of consent for medical treatment of a minor?

I, , parent or legal guardian of __, born , do hereby consent to any medical care and the administration of anesthesia determined by a physician to be necessary for the welfare of my child while said child

What is a good example of informed consent?

I understand that my participation is voluntary and that I am free to withdraw at any time, without giving a reason and without cost. I understand that I will be given a copy of this consent form. I voluntarily agree to take part in this study.

How to write a consent form for minors?

I, _ (name of parent), am the (mother) (father) of _ , aged , and do hereby give my consent for (him)(her) to travel with (name/address of traveling

In which situations can minors give consent for themselves for medical treatment?

A minor has the same capacity as an adult to consent to medical or dental treatment if the minor is living separate and apart from the minor's parent, parents, or guardian, whether with or without consent of the minor's parent, parents, or guardian and is self–supporting, regardless of the source of the minor's income.

What is a consent for treatment form?

A healthcare consent form is a legal document that outlines a patient's agreement to receive a particular treatment, procedure, or disclosure of their medical information.

For pdfFiller’s FAQs

What is St. Cloud State University Student Health Services - Minor Consent to Treatment Form?

It is a form that allows minor students to seek medical treatment at the St. Cloud State University Student Health Services with the consent of a parent or guardian.

Who is required to file St. Cloud State University Student Health Services - Minor Consent to Treatment Form?

Any minor student under the age of 18 who wishes to receive medical treatment at the university's health services is required to file this form.

How to fill out St. Cloud State University Student Health Services - Minor Consent to Treatment Form?

The form should be filled out by the parent or guardian, providing necessary information such as the child's name, date of birth, and specific consent for medical treatments, and then submitted to the health services.

What is the purpose of St. Cloud State University Student Health Services - Minor Consent to Treatment Form?

The purpose of the form is to provide legal consent for a minor to receive medical care and ensure that parents or guardians are informed about their child's health services.

What information must be reported on St. Cloud State University Student Health Services - Minor Consent to Treatment Form?

The form must report the minor's full name, date of birth, details of the parent or guardian giving consent, and specific medical treatments being consented to.