Medical Release Form?

This is what I give my parents when they have my kids-along with an extra insurance card or copy of insurance card. HTH

S.

January 1, 2007

To Whom It May Concern:

This letter authorizes (grandparents or other temporaty caregivers name(s))to make any medical decisions as needed while our son(daughter) , (Child's name), is visiting with them, and under their care.

Parent(s)names and signatures

Hi L.:

I don't have our electronically any more, but here is the gist of it. Sorry, this will be a bit long. It is titled Emergency Medical Authoriation. The following fields are listed with answers: Child's Name, Date of Birth, Address, Parents' Names, Home Phone, Dad's Cell, Mom's Cell, Dad's Work #, Mom's Work #, Dad's email, Mom's email, Medical Facility (hospital you prefer), Pediatrician's Name, Child's Allergies, Current Prescribed Medications, Child's Special Medical Needs and Condition.

The following paragraph is followed by the parents' signatures and date, as well as the signature of a witness and date.

In the event of an emergency involving my child, or should my child suffer an injury or illness while in the care of (insert caregiver's name/s)and he or she is unable to contact me (us) immediately, he or she shall be authorized to secure such medical attention for my child, as may be necessary. I agree to be fully responsible for all medical expenses incurred during the treatment of my child.

Each child should have their own form.

Have fun in Vegas!!!

Check with hospital or doctor. I used to just leave a note.

When we first had a sitter a couple of years ago, we typed up a letter giving authorization to that person to obtain medical attn if needed. It included insurance info and we got an extra card to put with it. We also listed numbers to call for additional info and basic doctor info. Then we had it notarized just in case. Luckily, it was never needed.
Since this will be Grandma, most places will consider her family though it won't hurt to have something on hand.

First of all let me say congratulations and I am super jealous!!

When we left the kids we left our insurance card and a hand written note saying you give them the power to make medical decision for the child upon your behalf, also try to leave a phone # just in case! Have a GREAT time!

Hi L.,

My husband and I do the same thing when we leave our two young children. The letter needs to state that you allow "names" to make medical decisions on treatment and seek medical treatment in your absence. State the dates that you will be gone in the letter, then both you and your husband need to sign it. It is so important to do this. My daughter had a terrible ear infection while my husband and I were across the country and my parents had to take her to the pediatrician. Some pediatricians will let you write a letter and update it once a year that can be kept in your child's chart telling them the people that can make medical decisions for your child/children. Although the separate letter in addition is a great idea in case, God forbid, they need to take your child to an ER. Good luck and have a safe vacation!

Pretty sure you just need to leave them with an insurance card and you can write and sign your own note.