Child Medical Consent - Pennsylvania

Pennsylvania · Fillable PDF · Free

This form lets a grandparent, babysitter, coach or other caregiver consent to medical care for your child while you are away. It is shorter than a full power of attorney and is commonly used for trips, camps and summer stays. This form lets a grandparent, babysitter, coach or other caregiver consent to medical care for your child while you are away.

Serving Pennsylvania. Appointments require a Pennsylvania-commissioned notary.

Download Child Medical Consent - Pennsylvania PDF · 3 pages. No account required.

Book a notary for Child Medical Consent - Pennsylvania

Who this form is for

This form lets a grandparent, babysitter, coach or other caregiver consent to medical care for your child while you are away. It is shorter than a full power of attorney and is commonly used for trips, camps and summer stays.

What you'll need

The original Child Medical Consent - Pennsylvania packet and its instructions.
The names, dates and supporting records identified in this packet.
Acceptable identification if a notarial act is requested; arrange any required qualified witnesses.

How to complete it

Enter the child and parent details Use the child’s full legal name and date of birth.
Name the caregiver Include a phone number the doctor can call.
Add insurance and medical information List allergies, medications and conditions.
Parent(s) sign before a notary Bring a current photo ID.

Related Pennsylvania forms

Pennsylvania · Fillable PDF · 3 pages · Free

Minor Child Travel Consent - Pennsylvania

Airlines, cruise lines and border officers (including U.S. Customs and Border Protection and other countries’ immigration officers) may ask for written consent from a parent who is not traveling with a child. A notarized letter is the form most often accepted.

View Minor Child Travel Consent - Pennsylvania · Download Minor Child Travel Consent - Pennsylvania

Pennsylvania · Fillable PDF · 5 pages · Free

Power of Attorney for a Minor Child - Pennsylvania

Parents use this form to let a grandparent, relative or trusted adult care for their child while the parents are away, such as consenting to medical care, handling school matters, or traveling with the child. It does not change custody.

View Power of Attorney for a Minor Child - Pennsylvania · Download Power of Attorney for a Minor Child - Pennsylvania

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.

Free legal forms by state · Book a mobile notary