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Parental Consent Form
 

Parental Consent Form

Protecting your children while you travel means more than getting a sitter. To be absolutely safe, you should provide written authorization for a responsible adult to approve any necessary emergency medical treatment for your children.

Unless a child’s injuries are life-threatening, hospital personnel and physicians cannot treat him or her without parental or guardian consent. As a result, your child may suffer unnecessary discomfort while waiting for you to be reached to approve stitching a cut or setting a broken arm.

Each time you go out of town, complete a ‘Consent for Medical Treatment of a Minor’ form. A separate, dated consent form is necessary for each of your children each time you leave town.

 
  St. Joseph Hospital
700 Broadway
Fort Wayne, IN 46802
(260) 425-3000
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