Medical Emergency Form Instructions
Simple, clear instructions showing you how to fill out the Arizona Children's Medical Emergency form.

Arizona Children's Medical Emergency Form Instructions
Simple, clear instructions showing you how to fill out your Children's Medical Emergency Form.
Information on Children's Medical Emergency Forms
Answers to Frequently Asked Questions About Your Children's Medical Emergency Forms
Who
is a Minor?
What
is an "Attorney-in-Fact?"
Completing the Forms
How
to Complete the Forms
Where
To Keep The Forms
What
To Do About Baby-Sitters Who Are Not Old Enough To Be Attorneys-in-Fact
How
To Revoke A Power Of Attorney
Instructions
Information on Children's Medical Emergency Forms
The Problem
Most doctors and hospitals throughout the United States will render only essential
lifesaving services to a minor child without the consent of a parent, legal guardian or other
adult who is specifically authorized, in writing, by a parent or guardian to consent to the medical,
surgical or dental treatment. Consequently, a seriously ill or injured child may not get
all the treatment he or she needs when it is needed. If a parent
or legal guardian is unavailable to sign a medical treatment consent form, many useful and vital
medical services may not be rendered until the proper approval can be obtained by the doctor
or hospital. The risk of insufficient medical care exists whenever a parent or legal guardian
is not with his or her child (for example, when the child is at school or when the parent or
guardian is at work, out for the evening, or on vacation).
The Solution
Most parents and legal guardians have friends, relatives, neighbors and baby-sitters
who could consent to medical treatment in the parents' or guardians' absence. Most doctors
and hospitals, however, will accept the consent of such a person only if
the parent or guardian authorizes, in writing, that person to give the consent. This CHILDRENS
MEDICAL EMERGENCY KIT contains all the forms and instructions necessary to enable a parent or
guardian to authorize other people to give these consents for the parent or legal guardian. The
forms are simple to use, but it is important that you read these instructions before attempting
to use them.
Answers to Frequently Asked Questions About Your Children's Medical Emergency Forms
Who is a Minor?
This varies from state to state, and is as high as 21 years in some states. In
Arizona, anyone under age 18 is a minor.
What is an "Attorney-in-Fact?"
Each relative, friend, neighbor and baby-sitter authorized to consent to medical
care for your child or children is referred to under the law as your "Attorney-in-Fact." This
term has nothing whatsoever to do with "attorneys at law" or "lawyers." Anyone who is over
the age of majority (an adult) and of sound mind can be appointed as your "Attorney-in-Fact" to
consent to medical care for your child(ren).
Completing the Forms
How to Complete the Forms
We recommend that you use a separate form for every adult who will be authorized
to consent to medical treatment for your child(ren).
After the form has been properly filled-out, it should be signed by both parents or legal guardians in the presence of a notary public. The form is set-up so that each person may sign at a different time, if that is most convenient. In the case of divorced or legally separated parents, if it is not possible to obtain the signature of the parent who does not have legal custody, only the parent who was awarded custody by the court needs to sign.
Most states, including Arizona, do not require that this type of Power of Attorney be notarized, but many people do not know this and they may not accept your Power of Attorney if it is not notarized. However, there may be times when it is not possible for you to sign in the presence of a notary public. In those situations, you should draw an "X" through each of the notary signature boxes. This may avoid confusing people who might otherwise think the form has not been completed.
Where to Keep the Forms
Each person who is made your Attorney-in-Fact should keep the original of
his or her own form. Obviously, the form should be kept in a convenient place so it can
be located quickly if needed. Each Attorney-in-Fact should be instructed to take the original
form with him or her if it ever becomes necessary for that person to consent to medical treatment
for your child(ren). The doctor or hospital may want to see the original form before permitting
your Attorney-in-Fact to make the consent.
What
To Do About Baby-Sitters Who Are Not Old Enough To Be Attorneys-In-Fact
Our CHILDRENS MEDICAL EMERGENCY KIT contains a sheet entitled "MEDICAL TREATMENT
CONSENT LIST" on which you should print the names, addresses and telephone numbers of all persons
you have made your Attorney-in-Fact. This sheet should be kept in a convenient place in
your home and shown to all baby-sitters who stay with your child(ren). The baby-sitter
should be instructed that if a sudden illness or injury occurs to your child(ren), and you cannot
be reached, he or she should start at the top of the list and contact each person until one of
them can be reached who will go directly to your doctor or to the hospital to consent to treatment.
How to Revoke a Power of Attorney
The easiest way to revoke this Power of Attorney is to have it returned to you and
destroy it. You should then notify all doctors and hospitals who may have relied on it
in the past of your having revoked it. You can revoke one or more Powers of Attorney without
affecting the validity of others.
If you wish to revoke a Power of Attorney and your Attorney-in-Fact refuses to return the original form to you, you may use the Revocation form included in this website under the heading "Do Your Own Durable Power of Attorney."
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