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Legal Guardian Medical Consent Form
"I need a Legal Guardian Medical Consent Form for my niece who will be staying with me for six months from January 2025 while her parents are working abroad, including authorization for both routine medical care and any emergency treatments at our local hospital in Cardiff."
1. Guardian Information: Full legal details of the appointed guardian(s) including name, address, contact information, and relationship to the child
2. Child Information: Full details of the child including name, date of birth, NHS number, and any relevant medical conditions
3. Scope of Authority: Specific medical decisions the guardian is authorized to make, including routine care, emergency treatment, and specific procedures
4. Duration: Time period for which the consent is valid and any conditions for termination or renewal
5. Emergency Contact Information: Contact details for guardian and alternative contacts in case of medical emergencies
1. Specific Treatment Exclusions: List of any medical procedures or treatments specifically excluded from the guardian's consent authority
2. Religious/Cultural Considerations: Documentation of specific religious or cultural requirements that may affect medical treatment decisions
3. Alternative Guardian Designation: Designation of secondary guardian and their authority in cases where primary guardian cannot be reached
1. Schedule A - Medical History: Detailed record of the child's relevant medical history, allergies, and ongoing conditions
2. Schedule B - Proof of Guardianship: Legal documentation confirming guardian status and authority
3. Schedule C - Healthcare Provider Information: Comprehensive list of regular healthcare providers, specialists, and their contact information
4. Schedule D - Insurance Information: Details of medical insurance coverage and relevant policy information
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