Minor Consent Form - Help!

[hockeymom7691]

My son is leaving on Sunday for a Hockey Camp in Chicago. He will be staying with the Coach who is running the camp.

I was searching the web trying to find some type of consent form for medical emergencies and to give the coach guardianship for the week.

I did find all kind of forms but they all are PDF files (Adobe). I have no clue how to use these forms.

Does anyone know how you download those forms/files to complete them or have any other suggestions?

Thanks for any help!

 

[Annette_VA]

You can download the Adobe Acrobat reader, then just print them off & fill them out.

http://www.adobe.com/products/acrobat/readstep2.html

 

[hockeymom7691]

I have adobe acrobat reader. The forms I'm finding need to be revised somewhat and that's what I can't figure out.

Is there a way to copy & paste them so that I can edit the forms?

 

[Annette_VA]

Oh, no, you can't edit a .pdf

 

[Tigger&Belle]

Can you copy and paste it into Word and then make any changes?

T&B

 

[wovenwonder]

Medical Care Authorization Form

I, XXXXXXX [father of minor] and XXXXXXXX[mother of minor] do hereby appoint XXXXXXX. [Uncle of minor] to seek and obtain medical care and treatment, for our child XXXXXXXX which he believes to be necessary for the health and well being of our minor child including any surgery authorized by a licensed physician.
I give and grant unto him full power and authority to do and perform all and every act, deed and matter and things whatsoever to promote the health and welfare of my said child as fully and effectually to all intents and purposes as I might or could do in my own proper person if personally present. I hereby declare that any act or thing lawfully done hereunder shall be binding on me.
Dated and effective for one month beginning this 5th day of August 2004.


____________________________________________________
Signature of parent


childs name
Birth date – XXXXX
Allergy to [list allergies]
Currently taking [list any medications here]
Medical Insurance –[list medical insur info here]

 

[hockeymom7691]

Thanks Jody. I also found some on the web in word format so I was able to print those.

I can't believe my baby (so what if he's 13) is going to be away for a week! It will be really good for him but I'm not so sure about me!

 

[DebbieB]

Originally posted by Tigger&Belle
Can you copy and paste it into Word and then make any changes?

T&B

I don't believe you can copy and paste a .pdf. My company uses .pdf to send proposals over e-mail so that they cannot be altered.

 

[ahutton]

Parental Permission and Medical Consent



DD Name
Date of Birth
Home Address
Home Phone

I, *my Full name*, do hereby give my consent for my daughter, *DDs Full name*, to travel with *my Father's full name* and/or *my Mother's full name*. Further I authorize them, on my behalf, to consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment, and hospital care which is deemed advisable by and is rendered under the general or specific supervision of any physician and surgeon licensed under the provision of the Medical Practice Act, whether such diagnosis or treatment is rendered at the office of said physician or at a hospital, during all times that *my Daughter's full name* is in the presence of *my Father's full name* and/or *my Mother's full name*.

It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required, but is given to provide authority and power on the part of *my Father's full name* and/or *my Mother's full name* to give specific consent to any and all such diagnosis, treatment or hospital care which the physician, in the exercise of his best judgment may deem advisable.

Health Insurance Information:

Company Name
Group Number
ID Number

Claims Address:
Company Name
P.O. Box
Dallas, TX 75226-0044

No known medical conditions. No known allergies. Blood type unknown at this time – Mom is A+; Dad is O+. All immunizations current up to *age* year old preventative care visit.

X_________________________________________________

_
*My full name*, Mother and natural parent


This was taken from forms I work with, and also some blank forms I found on the subject. I figured it covered all possibilities. Fortunately she never needed it!