Patient authorizes the physicians, medical attendants, and the hospital to furnish full and complete medical information to the specified attorney at law, or to any representative or investigator from his/her firm. The form also provides that all prior authorization is cancelled.
Medical Authorization Form For Minor In Minnesota
Category:
State:
Multi-State
Control #:
US-00426
Format:
Word;
Rich Text
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Dear Parent(s): State law requires that you consent to most medical treatments for your minor child. Use our Child Medical Consent form to let someone make medical decisions for your child in your absence.Important: Please read all instructions and information before completing and signing the form. An incomplete form might not be accepted. Minnesota has state laws that allow minors to consent to certain types of services without parent or guardian permission. Note: A signed parent consent form lasts until the child turns 18, un- less withdrawn. If the consent form is not returned, anyone under 18. Complete this form to give Mayo Clinic Health System permission to treat a minor if a parent or legal decision maker cannot be present prior to treatment. This form is used to authorize Blue Cross to release your protected health information (PHI) to another person or entity. This compilation includes state, District of Columbia, and territory statutes as of January 2013 regarding minor consent laws to medical treatment.