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Lebanon
  • (717) 274-9775
  • 927 Russell Dr, Lebanon, PA 17042
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Lebanon(717) 274-9775

Top Rated ENT Doctors in Lebanon, PA | Melnick, Moffitt, & Mesaros ENT Associates

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Before Your Child’s Appointment

Before Your Child’s Appointment
Before Your Child’s Appointment

Preparing For Your Child’s Appointment

Minor Child Consent Form

Under the Medical Consent Act, a parent or legal guardian of a minor can confer upon an adult who is a relative or family friend the power to consent to a child's medical treatment. The parent or guardian may also confer any existing parental rights to obtain records and information with regard to the healthcare services and insurance. An authorization to allow access to medical information given under this Act would supersede any lack of the person designated being on the HIPAA authorization form.

This form is NOT needed (presence of parent or legal guardian not required) for:

  • MINORs who have (a) graduated from high school, (b) been pregnant (even if they never gave birth) or (c) married and are able to consent to ALL medical services and treatment for themselves and any minor children of their own.
  • MINORs who have obtained a judicial order of emancipation.
  • MINORs can consent for testing or treatment for any reportable diseases;
  • In emergency situations, when an attempt to secure consent (either from the parent/legal guardian of child) would increase any risk to a minor's life or health, such consent is not needed.

For divorced parents, unless one of the parents can show a court order that says the other parent's LEGAL CUSTODY (not just physical custody) was taken away from them, either parent has the right to fill out the Medical Consent Act form.

If there is an Order of Court saying the Children and Youth Services, and NOT the parents, have legal custody, then neither parent has the right to initiate the Medical Consent Act.

Use the link below to download a copy of the Minor Child Consent From.

Minor Child Consent Form
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TestimonialView All

“Went to Dr. Melnick hoping for a good hearing aid test so I can get the right hearing aid. After examining me, he placed a tube in my ears and sent me home with perfect hearing with no need for a hearing aid. Thanks Dr. Melnick.

Adel Botros
BlogsView All
Nasal Obstruction in Children

Nasal Obstruction – My Child Stuck Something in Her Nose

Tonsillitis Causes And Cure

What You Need to Know About Tonsillitis

Pediatric Ear Infections

Pediatric Ear Infections (Ear Tubes)

Hearing Problems in Children

Does My Baby Hear Me?

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About Us

Melnick, Moffitt & Mesaros ENT Associates is the most highly rated otolaryngology practice in Lebanon PA. We take pride in offering compassionate ear, nose, throat,hearing and allergy care to patients of all ages.

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Lebanon, PA

927 Russell Dr, Lebanon,
PA 17042, USA

(717) 274-9775
Mon-Fri: 8:30 am - 4:30 pm
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