Minor Consent Form

In most circumstances it is required to obtain legal guardian consent prior to treating a minor (17 years of age or younger). Any adult who is not the legal guardian may not consent to treatment for a minor unless authorized by the legal guardian. Unfortunately, we are unable to authorize treatment based on verbal consent. To authorize and appoint agents to make medical decisions for your minor child please fill out the Authorization to Consent to Treatment of a Minor form.

• With the minor’s consent, a physician may give birth control procedures, information, and supplies to any minor of any age who requests and is in need of them.
• A pregnant minor of any age may authorize prenatal, delivery, and post-delivery medical care for herself related to the intended live birth of a child.
• A minor of any age may consent for her own abortion services.
• Upon the minor’s consent, a physician may diagnose, prescribe for, and treat a minor of any age for a sexually transmitted infection.
• Upon the minor’s consent, qualified medical practitioners and facilities may examine and treat a minor of any age for HIV infection.
• Family planning services must be made available to all minors, regardless of their age, based on the minor’s consent.
• When a minor “indicates that he or she was the victim of a sexual offense,” a physician may, with the minor’s consent, perform customary and necessary examinations to obtain evidence of the sexual offense and may prescribe for and treat the patient for any immediate condition caused by the sexual offense.
• A minor who is 15 years of age or older may consent to receive mental health services to be rendered by a facility or a professional person.
• With the minor’s consent, a physician “may examine, prescribe for, and treat such minor patient for addiction to or use of drugs without the consent of or notification to the parent, parents, or legal guardian of such minor patient, or to any other person having custody or decision-making responsibility with respect to the medical care of such minor patient.”
• “An alcoholic, including a minor, may apply for voluntary treatment directly to an approved treatment facility.”
• “An intoxicated person or person intoxicated or incapacitated by alcohol, including a minor, may voluntarily admit himself or herself to an approved treatment facility for emergency treatment.”
• A minor 15 years of age or older who is living separate and apart from his or her parent, parents, or legal guardian, with or without the consent of his or her parent, parents, or legal guardian, and is managing his or her own financial affairs, regardless of the source of his or her income may give consent to organ or tissue donation or the furnishing of hospital, medical, dental, emergency health, and surgical care to himself or herself.”
• Any minor who has contracted a lawful marriage may give consent to organ or tissue donation or the furnishing of hospital, medical, dental, emergency health, and surgical care to himself or herself.
• A minor “who has been sentenced to the youthful offender system pursuant to this section” can consent to “hospital, medical, mental health, dental, emergency health, or emergency surgical care” without the consent of a parent or legal guardian.