How to Fill Out a Minor Medical Consent Form in Texas

A minor medical consent form in Texas is a written authorization letting a qualified non-parent approve medical, dental, psychological, or surgical care for your child when you cannot be reached. Texas Family Code § 32.002 requires five things on the form: the child’s name; the name of one or both parents (if known) and any managing conservator or legal guardian; the name of the person giving consent and that person’s relationship to the child; a statement describing the nature of the treatment being authorized; and the date the treatment is to begin.¹ The form must be in writing, signed by the person giving consent, and physically delivered to the doctor, hospital, or other facility providing the care. A phone call does not satisfy the statute.

Who You Can Name as the Consenting Adult

Section 32.001 limits non-parent consent to a specific list, and it only operates when the person who normally has the right to consent cannot be contacted and has not given notice to the contrary.² Three relatives can consent on their own authority, without any advance paperwork from you: a grandparent, an adult brother or sister, and an adult aunt or uncle. Adult means 18 or older.

Anyone else needs a written authorization from the parent or guardian. That includes an educational institution and, most commonly, “an adult who has actual care, control, and possession of the child.” This is the category that covers a babysitter, a family friend, a nanny, a coach, or a step-parent who isn’t a conservator. If you are leaving your child with someone outside the grandparent/sibling/aunt-uncle circle, the written form is what gives that person authority.

A few narrower categories round out the list: a court with jurisdiction over a suit affecting the parent-child relationship, an adult responsible for a child under juvenile court jurisdiction, and a peace officer who has lawfully taken custody of a minor and reasonably believes the child needs immediate care.²

What to Write in Each Field

Start with the five statutory items. Then add the practical details providers actually ask for at intake, because a caregiver at the front desk cannot fill these in on your behalf.

Child’s full legal name and date of birth. Hospitals use both together for identification.
Names of both parents where applicable, plus any managing conservator or legal guardian. If a court order names a specific conservator, list them.
The caregiver’s full name and their relationship to the child (grandmother, uncle, family friend, coach).
A description of the treatment authorized. This is where homemade forms often stumble. “Any and all medical care” reads as too vague for a cautious provider. Better to list the general categories you are authorizing: emergency treatment, routine office visits, diagnostic imaging, dental care, prescriptions. Note any specific exclusions in the same section, such as objections to particular medications or procedures on religious or personal grounds.
The date treatment is to begin. Pair it with an expiration date tied to a specific trip, camp session, or school year. An open-ended authorization is more likely to be questioned and can linger after your circumstances change.
Known allergies and current medications.
Health insurance information: carrier, policy number, group number, and the name of the primary insured.
Phone numbers for both parents or a parent and a backup contact, so the provider can still reach someone with full legal authority.

You can use a pre-printed template from a hospital system or pediatric office, or you can draft your own. Either works, so long as the five items in § 32.002 are on the page.

Signing and Notarization

The statute requires the consenting person’s signature. It says nothing about notarization, and a signed, dated form handed to the provider legally satisfies § 32.002.¹ In practice, many clinics and hospitals ask for a notarized signature as an internal liability policy, because a notary’s seal confirms identity and cuts off later claims of forgery.

Texas caps notary fees: no more than $10 for the first signature acknowledgment, $1 for each additional signature, and up to $25 extra for an online notarization.³ Banks, shipping stores, and many law offices have a notary available. Sign in front of the notary; they cannot notarize a signature they did not witness.

If notarizing is not practical before the trip or the handoff, the form is still valid without it. The risk is delay: a particular office’s policy may hold up intake until they can reach you by phone.

What This Form Does Not Cover

The § 32.001 authorization has real limits, and it helps to know them before you rely on the form.

Immunizations. Section 32.001 does not apply to vaccines.² A grandparent who can authorize stitches or an X-ray cannot authorize a flu shot under this section. Immunization consent falls under § 32.101, and a caregiver who needs to handle vaccines requires a separate form addressing that specifically.

Custody orders that reassign medical decision-making. If you are divorced or separated, the conservatorship order controls who can consent to medical treatment. Joint managing conservators typically both hold that right, but a court order can assign medical decisions exclusively to one parent.⁴ Read your order before delegating. If the other parent holds exclusive medical authority, your consent form may not hold up. And § 32.001 only kicks in when the person with the right to consent “cannot be contacted” and “has not given actual notice to the contrary” — if a co-parent objects, the form is effectively blocked.²

Situations where the minor consents for themselves. Under § 32.003, a minor can consent to their own treatment in several situations, including active military duty, living apart from parents and managing their own affairs at age 16 or older, treatment of a reportable communicable disease, pregnancy-related care other than abortion, and treatment for drug or chemical dependency.⁵ Texas also allows minors to self-consent to counseling for suicide prevention, addiction, or abuse.⁶ In these situations no consent form from you is needed.

True emergencies. Hospitals will stabilize and treat a child in a life-threatening situation regardless of whether the consent paperwork is in order. The form matters most for the routine visit, the scheduled dental appointment, and the sports physical, where a provider has time to check authorization and can decline to proceed without it.

Getting the Form to the People Who Need It

Give the signed original to the adult who will be supervising your child. School nurses, camp directors, and coaches often collect these forms at the start of a season and keep them on file. When care is needed, the caregiver presents the form to admissions staff or the treating physician.

Expect the provider to check that the form actually covers the treatment being requested and that the authorization is still within its dates. Staff may also call you using the phone number on the form to confirm, especially for anything past routine care. Keep a photo or scan on your phone as a backup. Paper gets lost, and it tends to go missing during exactly the kind of urgent situation the form was written for.

1
State of Texas. Texas Family Code Section 32.002 (2025) – Consent Form
2
State of Texas. Texas Family Code FAM 32.001
3
Office of the Texas Secretary of State. Notary Public Educational Information
4
State of Texas. Texas Family Code Section 153.073 (2025) – Rights of Parent at All Times
5
State of Texas. Texas Family Code FAM 32.003
6
Texas Health and Human Services. Texas Health Steps Adolescent Health – A Guide for Providers