Keys? Check! Gas tank filled? Check!
Luggage packed? Check! Kids dropped off at my brother's? Check!
My wife and I are ready for a weekend out of town, right?
Wrong!
As parents, we have all taken trips, get-away
weekends, or simply a night out without our children. When
doing so, we make sure that a sitter or a relative is lined
up to watch the children. However, usually we forget to provide
for a situation where the children might become sick or injured
and need medical care.
Anyone who has ever presented a sick or
injured child to an emergency room or neighborhood care center
can testify to the fact that care cannot be rendered until
a parent and/or legal guardian has given authorization for
the care to be given. In a life-threatening emergency, care
would be rendered. However, in the case of an ear infection
or a cut requiring stitches, the medical provider will require
an authorization before proceeding to treat the child.
At the end of this article, I have drafted
a Medical Authorization Form, which has been printed in a
large enough format for use by you. Print it and use it.
This form can be used not only in the
situation where you are out of town, but also in an instance
where your child is out of town, such as on a bus trip or
traveling with neighbors. You can also use the form in conjunction
with day-care for your children, or the occasion when a neighbor
is watching your children. Lastly, the form also can be used
in the situation where you are watching a neighbor's child.
Please take the time to print and fill
out the form. While the form will not do away with the anxiety
of "what if one of the kids gets sick", it will
alleviate the uncertainty of whether your child will be able
to acquire medical care if you are not present.
MEDICAL AUTHORIZATION FORM
I, ___________________________, being
the parent and/or legal
guardian of ________________________ (hereinafter, my child[ren])
do hereby authorize _____________________________ to seek
and
obtain medical care for my child(ren) in the event that my
child(ren)
need(s) medical care.
My child has the following allergies:
__________________________.(if applicable)
I agree to be financially responsible
for the cost of any medical care
provided to my child(ren) under this Authorization.
My health insurance carrier is ________________________
and my
Policy or Certificate number is _______________________.
Date ______________________
Signature of Parent (or Legal Guardian)
_____________________
Witness Signature _____________________
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