Free Minor Child Power of Attorney Template
MINOR CHILD POWER OF ATTORNEY
I. Introduction
I, John Doe, residing at 123 Elm Street, Springfield, IL 62701, hereby grant power of attorney to [Your Name], residing at [Your Company Address], to act on behalf of my minor child, Jane Doe, born on April 15, 2045, in matters related to medical emergencies, as described below:
II. Purpose of Power of Attorney
This Power of Attorney is granted for the specific purpose of authorizing [Your Name] to make medical decisions on behalf of my minor child, Jane Doe, in situations where I am unable to do so due to temporary absence, incapacity, or unavailability.
III. Scope of Authority
[Your Name] is authorized to make all decisions regarding the medical care and treatment of my minor child, Jane Doe, including but not limited to:
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Consent to medical treatment, surgery, or procedures deemed necessary by healthcare professionals.
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Accessing and reviewing medical records and information about the health and well-being of my minor child.
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Consultation with healthcare providers, specialists, and other professionals involved in the care of my minor child.
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Making decisions regarding medication, therapies, and other medical interventions as deemed appropriate by healthcare professionals.
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Authorization to pick up and administer prescription medications for the minor child.
IV. Duration of Authority
This Power of Attorney shall remain in effect from the date of execution until December 31, 2050, unless revoked earlier by me, John Doe, in writing. The revocation must be delivered to [Your Name] promptly.
V. Emergency Contact Information
In the event of a medical emergency involving my minor child, healthcare providers, and authorities may contact [Your Name] at [Your Company Number] to make timely and informed decisions on behalf of my minor child. Additionally, my contact information is as follows:
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Phone: (555) 123-4567
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Email: john.doe@email.com
VI. Provisions for Communication with Parent/Guardian
[Your Name] should provide regular updates and notify me, John Doe, of any significant changes in my child's condition or before major medical procedures.
VII. Witness Affirmation of Capacity
We, the undersigned witnesses, affirm that, to the best of our knowledge, John Doe is of sound mind and fully capable of understanding the implications of granting power of attorney for their minor child.
VIII. Legal Disclaimer
This Power of Attorney is specifically limited to matters related to the medical care and treatment of the minor child named herein. It does not grant the designated agent any authority over matters unrelated to the child's healthcare, education, or general welfare.
IX. Review and Update Clause
The parent or legal guardian is encouraged to review and update this Power of Attorney periodically, especially in the event of significant life changes such as relocation, divorce, or changes in the child's medical condition.
IN WITNESS WHEREOF, I have executed this Minor Child Power of Attorney on 20th August 2050.
John Doe
20th August 2050
[Your Name]
20th August 2050
WITNESS ACKNOWLEDGEMENT
We, the undersigned witnesses, hereby acknowledge that the above-named Principal has signed this Power of Attorney in our presence on the date stated above.
Michael Smith
20th August 2050
Susan Johnson
20th August 2050
NOTARY ACKNOWLEDGEMENT
On this 20th day of August in the year 2050, before me, a Notary Public in and for said County and State, personally appeared John Doe, known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged that they executed the same for the purposes therein contained.
Witness my hand and official seal.
Notary Public's Name: Margaret Thompson
My Commission Expires: August 20, 2055
