Parental Consent for School or Medical Treatment

This Parental Consent Form provides written authorization for a minor to receive school-related or medical care in the parent/guardian’s absence.

It includes:

• Parent/guardian and child information

• Authorization for medical treatment or school decisions

• Emergency contact details

• Space for signatures and notary acknowledgment

Format: Fillable PDF (print or complete digitally)

Use Cases: School trips, hospital admissions, extracurricular activities, daycare emergencies

Notarization: A notary section is included for added verification and acceptance

⚠️ Disclaimer:

This form is provided as a general template. Schools and healthcare providers may have their own requirements. Please confirm acceptance before use. Utsey Notary Services LLC does not provide legal advice.

Instructions:

Download instantly after purchase, complete the form, and have it notarized by Utsey Notary Services or any licensed notary of your choice before submitting it to your insurance company.