Medical Consent Release Form

A Medical Consent Release Form is a dual purpose document, and should be used religiously by any business providing services or education for children, minors, in general, or those otherwise dependent upon someone else for their care. Whether you run a summer camp, a private school, sports team, special needs facility or day care, it is prudent to maintain an updated, signed Medical Consent and Release Form for each of your attendees at all times.

The Medical Consent portion of the form designates the legal guardian of the dependent for whom the consent is being given. Their signature grants their permission for diagnosis, treatment and medication to be administered in their absence, and also provides you with an alternative representative, in the event that the legal guardian cannot be reached. The representative would bear the responsibility of making medical decisions for the child in the parent or guardian’s absence but, regardless, if there is an accident or illness, this document gives you the right to call a doctor or ambulance, and have the child treated.

The acknowledgement of the guardian’s financial responsibility releases you from any liability for medical costs related to an incident that takes place while the child is under your care. But, this clause does not protect you from legal actions regarding allegations such as gross negligence, and should not be considered a safety net in that sense. The General Release portion of the form does provide you with some protection from legal damages in case of injury, and places the responsibility of risk on the parent or guardian. However, if you operate a day camp, for instance, and one of the children becomes injured because of a safety hazard, you can still be sued quite heftily, regardless of the signed release. It is important to understand the meaning of “risk” as it applies to your business.

The general release portion of the form requires a child’s parent or legal guardian to list his dependent’s medical conditions, allergies, medications, health problems, family physician’s information, and everything necessary for a medical provider to intelligently administer aid to an injured child. It is wise to make certain that you have obtained each and every item of information listed, before the child is enrolled in your program. It is also a good idea to keep a data base or rolodex of your attendees’ names with their physicians’ and guardians’ telephone numbers in case of emergency, in addition to having this completed form on file.  You may have to produce the form at an emergency room or clinic.

Finally, the HIPPA act passed in 1996 places privacy requirements on medical issues. Thus, it is necessary for the guardian to also sign the appended HIPPA Authorization in order for the surrogate guardian, or representative, to be able to make decisions for the child. A wise parent will appoint a close family member or friend who knows the child’s medical status and issues, and one who is willing to act in place of the guardian.

There are likely to be additional other forms required for your type of business, which you can learn about from your state’s Secretary of State office. However, this general medical release form should be a staple in your daily operations involving children or dependents. A quick review by your attorney should help with any revisions or additions needed that might be relevant to your particular operation.