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UP Health System Medical Group clinics will not be responsible for confirming the authorized individual s continued consent if the situation changes. This does not give authorization for blood draws or x-rays/imaging. Children 16 or 17 Years Old Minors 16 or 17 years old MUST have a Parent/Legal guardian present for initial office visit or they will be asked to reschedule their appointment. This consent will expire in one year from date signed. Consent to treat minor without parent/guardian...

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What is consent to treat minor?

Consent to treat minor is the legal authorization given by a parent or legal guardian for a healthcare provider to treat a minor.

Who is required to file consent to treat minor?

Parents or legal guardians of minors are required to file consent to treat minor.

How to fill out consent to treat minor?

Consent to treat minor can be filled out by providing the minor's information, the parent or legal guardian's information, the healthcare provider's information, and signing the form.

What is the purpose of consent to treat minor?

The purpose of consent to treat minor is to give healthcare providers permission to provide medical treatment to a minor in case of an emergency or routine care.

What information must be reported on consent to treat minor?

The information reported on consent to treat minor includes the minor's name, date of birth, medical history, allergies, insurance information, and emergency contacts.

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