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What is Child’s Medical Consent for Grandparents | Free Forms

The child’s medical consent for grandparents allows a grandparent to seek medical treatment for a child instantly.

When a child is being cared for by a grandparent, a child’s medical consent for grandparents is ideal. It is the responsibility of a grandparent to make all healthcare decisions for the minor during the period they have been given consent and be available whenever the child is being diagnosed or receiving any treatment at a health facility.

The medical consent form for grandparents allows parents or legal guardians to transfer all responsibility for their child’s health care decisions to one of the child’s grandparents. According to the law of a respective state, this form should have a start and end date (the average duration lasting six months to a year). Once completed, the grandparents must present this form while the child is being treated or diagnosed at a medical facility.

A child’s medical consent for grandparents allows them to access medical care for your child swiftly. When a child is being cared for by a babysitter, grandparents, or other temporary caregivers, a child’s medical consent for grandparents is essential.

Medical consent forms are also known by other names.

They are:

  • Caregiver Consent Form
  • Child Medical Release Form
  • Medical Consent for Minors
  • Medical Authorization for a Minor

Under the relevant state law, a minor (child) power of attorney enables a parent to grant their child full control over the decisions made for them for a while (usually six months or a year). The state where medical care will be provided will govern the child’s medical consent for grandparents. Usually, this is where the child lives while the parent/guardian is unable to give consent.

The child’s medical consent for grandparents doesn’t require an explanation of why the parent has decided to give control over the minor, but it must be renewed when it expires to keep the relationship valid. Depending on the state, the certificate needs to be signed in the presence of a notary public or two witnesses not related by blood or marriage.

It is recommended that you sign this document in the presence of a notary public, even though it is not necessary.

Components of a Child’s Medical Consent Form

In this section, we have explained the details that should be included in a child’s medical consent for grandparents.

 They are:

  • Legal parent or guardian’s name: The addresses and names of the parents or guardians issuing the authorization to the grandparents.
  • The names and dates of birth of the children: The names and birth dates of all children whom the grandparents will care for.
  • The child’s residence address: Information on where the child who the grandparent will take care of lives. For example, Kingston St. Boston, MA 33455.
  • Grandparent’s details: The name, telephone number, and address of the grandparent who will be taking care of the child.
  • Treatment details: A list of the medical procedures over which consent has been given to the grandparent. Also, include the child’s blood type and other relevant medical details.
  • Proof of legal authorization: A declaration that there are no court orders that would prohibit a grandparent from accessing the child’s medical information.
  • Date of document’s authentication: Write the date when the document was verified. Authentication is done by a notary public, an office responsible for authorization, or a notarized agency.
  • The expiry date of the document:  This is the date after which the grandparent will no longer be caring for the child.
  • Signature: Finally, the parent or legal guardian and a witness must sign the document and include their signatures, signing dates, and written names.

The details below are not necessary for the child’s medical consent for grandparents. However, including them will assist medical centers when giving medical care to the child:

  • Father’s contact details
  • Mother’s contact details
  • Drug or food allergies that the child has
  • Special drugs, blood type, or other relevant details about the child
  • Doctor’s name and phone number
  • Provider of child’s insurance and policy number
  • State
  • County
  • The date
  • Name and title of Notary Public
  • Name of parent or legal guardian
  • State
  • Notary Public’s signature
  • Notary Public’s seal

Child’s Medical Consent Form Example

Here is a child’s medical consent for grandparents form example:

I,__ (name), the parent or legal guardian of __(name of child) living in ___(address), born on the______________ (date of birth), wishes to hand over my consent and health responsibilities of my child to______________(name of the grandparent) who will be entrusted to take care of the health welfare of my child and will be allowed to take any medical responsibilities on my behalf including any prompt decisions arising from any medical condition such as an emergency surgery necessitated by a doctor.

This declaration of partial issuance of responsibilities runs from this day_________(date) and will come to an end on the day of_________(date)

(Signature of parent/guardian) (date) ( print name)

(Signature of witness) ( date) ( print name)

(Father’s contact) ( mother’s contact)

Special information and medical information __(allergies, blood group, or special drugs)

(physician name) ( Physician telephone number)


(Policy number)

State of…….

County of….

Before me, _(name of notary) on the _(date) appeared (name of parent/guardian) who after their personal evaluation which they presented me with substantial evidence to back their candidate (name of the grandparent) whom they wish to grant medical consent and responsibilities over their child_______(name) and undertake any jurisdiction given to the authorizing party above.

I have fully validated the competence of the proposed temporary guardian, and I hereby certify under PENALTY OF PERJURY under states law of the state of________ (name of state) that the above information is true and valid.

(signature) __(seal)

Giving Responsibility to a Grandparent

A child’s responsibility is crucial and requires a great deal of care. There are many reasons why a grandparent should care for a child’s medical needs. A child may have excellent parents, but due to their work schedules and limited time, the child requires additional care. 

Below are the steps to follow when giving responsibility to a grandparent:

Check competence

If a grandparent is suffering from mental illness or another health issue, the decision to make a grandparent responsible for the child’s medical needs should be reconsidered. For example, suppose a grandparent has arthritis and can barely move around. In that case, that may not be an ideal situation to look after a child, or maybe they have dementia which would mean that they could forget important information.

This could be risky, especially if a child is undergoing medication. Driving skills are an important trait to look for while choosing a caretaker to ensure they can drive quickly to a medical facility in case of an emergency. In most situations, the grandparent drives the child to and from the hospital, which can cause concern if the grandparent is not in good health. It is also possible to appoint someone else to care for the child’s medical needs.


A child’s medical consent for grandparents expires, usually within six months to a year. However, this could be extended until the child turns eighteen. The grandparent should be available throughout the period when the parent is unavailable. Therefore, it is important for the parent or guardian to ask if the grandparent is available to cater to the child’s medical needs without any major distractions or constraints.

Stay updated

If a child receives medical attention, always request feedback from the grandparent and the child. It is a parent’s responsibility to be aware of all that is going on in the event that the medical consent form has to be changed or canceled. Request that the doctor or the child’s primary physician send you email updates on the child’s development. Therefore, it is the grandparent’s duty to inform the parent/guardian of the child of the treatment progress.

Download Free Forms

Here are free child’s medical consent for grandparents forms that can be customized as per needs:




















































    A child’s medical consent for grandparents offers them the opportunity to care for a child’s health when the need arises. Misconceptions about parents being revoked of their parenthood by using the child’s medical consent for grandparents should be nullified by educating the masses about this very important option for parents who have hectic work schedules or are away from their families. Grandparents are important in the upbringing of children. Therefore, they can be trusted with children’s health and be given medical consent from parents/guardians when the need arises.

    Frequently Asked Questions

    Do I need the child’s medical consent if I already have child travel consent?

    Yes. Suppose you are traveling with a child who is not yours. In that case, you will need a child’s medical consent for grandparents in addition to a child travel consent in case the child needs emergency medical treatment when a guardian cannot be reached and to specify the type of treatment that has been authorized or health information related to the child.

    How do I end the authority of the temporary caregiver?

    On the child’s medical consent for grandparents, you can indicate an end date. If you mention an expiration date, the caregiver’s authority is limited to that date. If you do not want to define an end date, you may reestablish control of a temporary caregiver’s duties by informing the temporary caregiver of your plans. If you do this, you should also notify any medical professional working on the caregiver’s behalf.

    Am I giving up my parental rights by using a child’s medical consent for grandparents?

    No, giving a temporary guardian medical consent does not revoke your parental rights.

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