A "Consent to Treat" form is a document filled out and signed by a parent or legal guardian that gives medical personnel the right to treat your child in the event of an emergency if you are not present. Consent to treat forms can be given to anyone who is placed in charge of your child's care.
Consent to Treat forms usually contain the following information:
Child's name.
Child's date of birth.
Insurance carrier and policy number.
Doctors' names and phone numbers.
Important medical history, including allergies and chronic conditions.
A statement such as: Any licensed physician, dentist or hospital may give necessary emergency medical service to my child (YOUR CHILD'S NAME) at the request of the person bearing this consent form.
Parent/Legal Guardian's signature.
You can find additional information on Consent to Treat forms and/or printer-friendly Consent to Treat forms on the following websites:
● St. Vincent Health website
● Family Fun website
● Footwork Publications website
● Children's Hospital of St. Louis website
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