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Travel & consent letters
A sworn consent allowing a named caregiver to authorize medical or dental treatment for your child while the child is in their care — useful for travel, camps, or temporary stays. Fill it in online, download a ready-to-sign PDF, and notarize in Ontario.
Word files are editable. Review any changes carefully before signing or uploading.
Also known as
CONSENT FOR MEDICAL TREATMENT OF A MINOR CHILD
I, ______, of ______, in the Province of Ontario, MAKE OATH AND SAY that:
I am the ______ of ______, born on ______ (the "Child"), and I have lawful authority to consent to the Child’s health care.
The Child’s Ontario health card number is . Known allergies, conditions, or medications are: .
From ______ to ______, I authorize ______ (______) to consent on my behalf to medical, dental, and emergency treatment for the Child where I cannot be reached.
This authorization is subject to the following limits or instructions: .
I make this statement to confirm the caregiver’s authority to act in the best interests of the Child.
SWORN / AFFIRMED before me at the ______________________ of ______________________, in the Province of Ontario, this ______ day of ______________, 20______.
_______________________________ _______________________________
A Commissioner for taking Affidavits Signature of Deponent
Consent for Medical Treatment of a Minor Child
A compact preview of this template
Parent / Guardian Information
Your full legal name
Child's full legal name
Caregiver's full name
CONSENT FOR MEDICAL TREATMENT OF A MINOR CHILD
I, ______, of ______, in the Province of Ontario, MAKE OATH AND SAY that:
I am the ______ of ______, born on ______ (the "Child"), and I have lawful authority to consent to the Child’s health care.
The Child’s Ontario health card number is . Known allergies, conditions, or medications are: .
From ______ to ______, I authorize ______ (______) to consent on my behalf to medical, dental, and emergency treatment for the Child where I cannot be reached.
This authorization is subject to the following limits or instructions: .
I make this statement to confirm the caregiver’s authority to act in the best interests of the Child.
SWORN / AFFIRMED before me at the ______________________ of ______________________, in the Province of Ontario, this ______ day of ______________, 20______.
_______________________________ _______________________________
A Commissioner for taking Affidavits Signature of Deponent
How it works
Answer the questions, choose the download you need, then continue with signing or booking.
Overview
It is a sworn statement authorizing another trusted adult to make health-care decisions for your child when you cannot be reached.
Hospitals, clinics, camps, and schools often ask for it when a child is in someone else’s care.
It supports a caregiver consenting to treatment.
After you fill in your consent for medical treatment of a minor child and download the PDF, do not sign it in advance. A sworn document must be signed in front of a notary public or commissioner for taking affidavits, who administers your oath or solemn affirmation first.
Minute Notary commissions your consent for medical treatment of a minor child online by secure video, under Ontario's remote commissioning rules (O. Reg. 431/20), or in person in Ottawa. Bring valid government-issued photo identification.
Frequently asked
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Other documents for travel, immigration & invitations.
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Fill it outA travel consent letter records permission for a child travelling without every person who has decision-making responsibility. The Government of Canada recommends carrying one, although it is not legally required in Canada.
Fill it outFill it in online, then download a ready-to-sign PDF or an editable Word copy. Use the generated PDF to continue to booking.