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Consent for Medical Treatment of Minor - Illinois

Illinois · Fillable PDF · Free

A parent uses this form to let a babysitter, relative, coach, or other adult consent to medical or dental care for a child while the parent is away. A parent uses this form to let a babysitter, relative, coach, or other adult consent to medical or dental care for a child while the parent is away.

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Who this form is for

Illinois residents and families reviewing consent for medical treatment of minor instructions.

What you'll need

Read the original packet’s instructions and complete only the fields that apply.
Bring acceptable identification and follow the packet’s signature and witness instructions.

How to complete it

Fill in the child and adults (Page 1) Include the parents, the person giving consent, and the adult who may consent to treatment.
Describe the treatment (Page 1) Authorize all advisable treatment or only specific treatment, and set the dates.
Sign in front of a notary Do not sign ahead of time. Bring a current, government-issued photo ID for each person signing.

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This Illinois statutory form lets a parent appoint someone to care for a child for up to one year without going to court, for example during a hospital stay, military deployment, or travel.

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When a child travels with only one parent, grandparents, a school group, or another adult, airlines and border officials may ask for written, notarized consent from the parents who are not traveling.

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These forms are a free convenience, not legal advice. First Choice Mobile Notary & Apostille is not a law firm. Consult an attorney licensed in the relevant state for legal questions.

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