PARENTAL CONSENT FOR MINORS UNDER 18 YEARS OF AGE: The law requires parental permission before medical or surgical treatment of a minor. The hospitals in our area have a similar requirement relative to admission and treatment. If such treatment becomes necessary, every effort will be made to obtain your specific consent before treatment. On occasion you may be unavailable. In order to avoid unnecessary delay, your prior consent to treatment is important. However, no surgical procedures will be performed without your specific knowledge and consent, except in cases of critical emergency.
I understand the considerations set forth above, consent to use of the above insurance policy and authorize any physician and any hospital involved to perform such medical or surgical treatments as me be deemed necessary for my son/daughter.