LDSS-0882. Consent for Childs Routine Medical and Dental Care

Form Consent for Childs Routine Medical and Dental Care is a NYS Office of Children and Family Services form that is used to provide consent for routine medical and dental care for a child from a person other than the parents or legal guardians. This form is used when a child is in the care of a person other than their parent or legal guardian and that person requires consent from the parents or legal guardians for routine medical and dental care.

The form consists of four sections: the first section is for the parents or legal guardians to provide information about themselves, including their name, address, and relationship to the child; the second section is for the person in charge of the child to provide information such as their name and address; the third section is for the parent or legal guardian to provide consent for the person in charge to obtain routine medical and dental care for the child; and the fourth section is for the parent or legal guardian to sign and date the form. Additionally, the form includes a box to indicate whether the parent or legal guardian wishes to receive a copy of the form.

Important fields in this form include the parent/legal guardian’s name, address, and relationship to the child; the person in charge of the child’s name and address; and the parent or legal guardian’s signature and date. Accurate completion of this form is critical for the person in charge of the child to obtain routine medical and dental care for the child.

This form may be used in a variety of scenarios. For example, if a child is in the care of a family member or non-parent caregiver and they require consent for routine medical and dental care. Specific instructions for completing the form include providing accurate details in the fields and signing and dating the form. The benefits or purposes of using the form are to provide evidence of the parent or legal guardian’s consent for the person in charge to obtain routine medical and dental care for the child.

Related forms or alternatives that may exist for similar transactions or purposes include the NYS Office of Children and Family Services Form “Consent for Emergency Medical and Dental Care”. Additionally, other documents may be needed in order to complete the form such as the child’s birth certificate or a copy of the parent or legal guardian’s