Travel & consent letters
Consent for Medical Treatment of a Minor Child
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.
Pay only when you notarize
Word files are editable. Review any changes carefully before signing or uploading.
Also known as
- Medical Consent Letter for a Child
- Authorization for Treatment of a Minor
- Caregiver Medical Authorization
+1 more names
- Child Medical Consent Form
CONSENT FOR MEDICAL TREATMENT OF A MINOR CHILD
I, ______, of ______, in the Province of Ontario, MAKE OATH AND SAY (or AFFIRM) 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 (if available):
Known allergies, conditions, or medications (if any):From ______ to ______, I authorize ______ (______) to consent on my behalf to medical, dental, and emergency treatment for the Child where I cannot be reached.
Limits or instructions on this authorization (if any):
I make this statement to confirm the caregiver’s authority to act in the best interests of the Child.
Signed and sworn (or affirmed/declared) before me by videoconference in Ottawa, Ontario, while the Affiant(s)/Declarant(s) were located in ______________________, on ______________________, pursuant to O. Reg. 431/20, and Electronic Commerce Act, 2000.
______________________________ | ______________________________ |
The blanks fill themselves in as you type.
- Scope
- General template, not legal advice
- Formats
- PDF + editable Word downloads
- Builder
- Live preview as you type
Consent for Medical Treatment of a Minor Child
A compact preview of this template
01Parent / 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 (or AFFIRM) 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 (if available):
Known allergies, conditions, or medications (if any):From ______ to ______, I authorize ______ (______) to consent on my behalf to medical, dental, and emergency treatment for the Child where I cannot be reached.
Limits or instructions on this authorization (if any):
I make this statement to confirm the caregiver’s authority to act in the best interests of the Child.
Signed and sworn (or affirmed/declared) before me by videoconference in Ottawa, Ontario, while the Affiant(s)/Declarant(s) were located in ______________________, on ______________________, pursuant to O. Reg. 431/20, and Electronic Commerce Act, 2000.
______________________________ | ______________________________ |
- 01Work your wayGuided or All fieldsFinish one section at a time, or see every question in one form.
- 02See the resultLive document previewWatch this document update as you add each answer.
- 03Keep your placeSave and restore a draftSave progress in this browser, then restore it later on this device.
How it works
Prepare your document, one step at a time.
Answer the questions, choose the download you need, then continue with signing or booking.
Overview
About this document
- 01
What is a child medical consent?
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.
- 02
When you might need one
It supports a caregiver consenting to treatment.
- Your child is travelling with a relative, friend, or group without you.
- Your child stays with a caregiver, camp, or host family for a period.
- A clinic or hospital asks who may consent to treatment in your absence.
- 03
How to notarize a consent for medical treatment of a minor child in Ontario
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.
- Fill in the form online and download a clean, ready-to-sign PDF — free, no account.
- Book an appointment and join online by video or visit us in Ottawa.
- Present valid photo ID; we administer your oath or affirmation and witness your signature.
- We apply the notary seal so the document is ready to use.
Good to know
Before you fill it in.
Short notes from our notary on this template. Worth a minute before you start.
- 01
Reviewed for use in Ontario by a notary public and commissioner for taking affidavits.
- 02
Fill it in online for free and download a ready-to-sign PDF — no account required.
- 03
Sign in front of the notary, who administers your oath or witnesses your signature and applies the seal.
- 04
Notarize online by video across Ontario, or in person in Ottawa.
Frequently asked
Questions about the Consent for Medical Treatment of a Minor Child
- Does this replace a parent’s consent?
- No. It authorizes a caregiver to consent when you cannot be reached. You keep your authority as a parent or guardian.
- Should both parents sign?
- Where both parents share decision-making, it is best practice for both to sign so the caregiver’s authority is not questioned.
- Can I notarize it online in Ontario?
- Yes. You can complete it online by video under Ontario’s remote commissioning rules, or in person in Ottawa with Minute Notary.
- What should it include?
- The child and caregiver, the authorization period, the health card number if available, and any allergies, conditions, or limits.
Keep exploring
Related templates
Other documents for travel, immigration & invitations.
- 01Consent to Travel for a Minor Child (Both Parents)
A sworn travel consent letter signed by both parents or guardians, authorizing a child to travel with a named third party such as a grandparent, relative, family friend, or school group.
Fill it out - 02Consent to Travel for a Minor Child (Sole Custody)
A sworn travel consent letter for a parent who has sole decision-making responsibility for a child, confirming their authority to authorize the child's travel without a second parent's signature.
Fill it out - 03Minor Travel Consent Letter (Canada)
A 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 out - 04DS-3053 Statement of Consent: U.S. Passport Issuance to a Child
The DS-3053 Statement of Consent, used when one parent cannot appear in person for a child’s U.S. passport application — it must be notarized. Fill in your details online, download a ready-to-sign PDF, and notarize in Ontario.
Fill it out
Ready to sign?
Ready to create your Consent for Medical Treatment of a Minor Child?
Fill it in online, then download a ready-to-sign PDF or an editable Word copy. Use the generated PDF to continue to booking. Not sure what the appointment involves? Read about the Immigration Documents service first.