Anyone written a 'permission to seek medical care" letter for when you were OOT?

jenn2929

DH and I are going out of town and MIL would like a letter giving she and FIL permission to take the kids for medical treatment, should they (g-d forbid) need it.  We have a notary here at work, so that's not an issue, I just have no idea what to write.

If you've written one, can you please send it to me so I can get a better idea of what I need to say?

jennylenny65atgmail

TIA

TamTam624

This is a letter I have for my parents I update it often since they watch DS while we work.  

 

Date:

 

 

To Whom It May Concern:

 

I  Insert Parent Name  give permission for Insert Name to authorize any medical procedures for my Insert Child?s Name or Names . His or their birth date is September xx, xxxx.

 

If you need any additional information, you can contact me at 555-555-5555.

 

A copy of my insurance card is provided.

 

 

 

Sincerely,

JustaKidAtHeart

This is what I used to make my letter when I need one.

 

Name of Child (children): ____________________________________________________________

I the undersigned give permission for caring for the above named Child(children) to
{Name of the person(s) who will be caring for the child}

_________________________________________________________________________________

Here is where I can be reached while away including phones and locations.

__________________________________________________________________________________

__________________________________________________________________________________

I hereby authorize the person(s) named above to sign for medical treatment of my child(ren)
between the following dates:
From: __________________ Until: ___________________

Parent Signature: ________________________ Date: ____________________

Witnessed By: ___________________________________________________
Phone: _________________________________________________________
Address: ________________________________________________________

Insurer: __________________________ Number: _______________________

EMERGENCY CARE INFORMATION

Child's full name: _________________________________________________
Date of Birth: __________________ Date last Tetanus Shot: ______________________
Child is allergic to the following medications: _______________________________________ ( ) None
Child is taking the following medications: _________________________________________ _ ( ) None
Child is diabetic, has other chronic condition or major illness:
_____________________________________________________________________________ ( ) None
Name of primary care physician and phone number__________________________________________

 

jenn2929

Thanks.  These are exactly what I'm looking for!

samk213

We use this medical release 

APPOINTMENT OF TEMPORARY GUARDIAN/MEDICAL AUTHORIZATION

            I, _______________, hereby appoint _______________ as Temporary Guardian (?Temporary Guardian?) of my minor child, ________________ (the ?Child?) whose date of birth is ___________________.

1.         I authorize the Temporary Guardian to administer general first aid treatment for minor injuries or illnesses experienced by the Child except where any such first aid treatment is specifically excluded hereunder:

2.         I authorize the Temporary Guardian, in the event that I cannot be contacted or if any urgency dictates, to act in loco parentis for the Child in respect of any circumstances, including any accident or illness, which may necessitate medical treatment, including surgery, and on my behalf to authorize any such treatment or surgery which they, in their sole discretion, (which discretion shall not be unreasonably exercised), may deem necessary. Medical treatment for the Child may also include dental surgery, x-ray, blood transfusion, anesthetic and medication provided any such medical treatment is performed by a duly licensed practitioner. I hereby accept full liability for all costs incurred through such medical treatment for the Child.

3.         Persons responsible should please note the following: (Please state aspects eg. allergies, tendency towards abnormal bleeding, epilepsy, etc.)

            Present prescribed, or other medication that is being administered:

None at this time. 

4.         The following information is essential in case of medical treatment or hospitalization:

            4.1.      Name and Address of Employer:

            4.2.      Medical Aid / Insurer:

           

5.         I declare that I am the legal custodian of the Child and that I have legal authority to grant medical consent to the Temporary Guardian for the Child.

6.         Unless inconsistent with the context, words signifying the singular shall include the plural and vice versa.

7.         This medical consent will be in effect from the _________________________.

Signed on _________________.

 

                                                                                   

PARENT

 

 

            Subscribed and sworn to before me on July ____, 2011, to certify which witness my hand and official seal.

 

 

                                                                                   

NOTARY PUBLIC, STATE OF TEXAS

 

 

                                                                                   

MY COMMISSION EXPIRES ON

 

di0607

Thanks to OP for asking. I just emailed myself some templates for use in the future!!

RoxBride

Our pedi has their names on file, and said that is the best way to handle it.

In an emergency no one would refuse to treat the child. In a non emergency, and the unlikely event that someone in the medical field refused to treat the child without the parent there, the pedi can confirm that the grandparents are okay'd.