Get Authorization To Consent To Treatment Of Minor - California State ... - Csulb

Filling out the Authorization To Consent To Treatment Of Minor form is essential for parents or legal guardians seeking to provide medical consent for their minor children enrolled at California State University, Long Beach. This guide will walk you through each section of the form, ensuring a smooth and precise completion.

Follow the steps to complete the form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in your editor.
2. In the first section, fill in the name of the minor as needed, ensuring that the name is clear and accurate.
3. Provide the student’s identification number in the designated field to confirm their enrollment status.
4. Enter the date of birth of the student, making sure it is formatted correctly to assist in age verification.
5. Print your name in the space for the parent or legal guardian's name, ensuring legibility for verification purposes.
6. Sign the document in the appropriate section to affirm your authorization for treatment.
7. Include the date on which you are signing, as this establishes the timeline for the consent provided.
8. Provide your address and contact numbers, including both home and cellular phone numbers, to ensure you can be reached in case of an emergency.
9. Review the completed form for accuracy before submitting it, ensuring that all information is correct.
10. Once all details are verified, save changes to the document, and you may choose to download, print, or share the form as needed.

Start completing your authorization form online today!