Another adult takes your child to the doctor: the authorization that makes it possible

It is the law that solves an everyday problem: the child needs a routine appointment and the parent cannot come along. Previously, the absence of the person with parental authority could stall care. The law creates consent by representation: any of the persons holding parental authority, after consenting to the non-urgent treatments recommended by an authorized health care provider, may authorize them to be provided without their presence being necessary.

Minors needing non-urgent medical treatment, when at least one of the persons with parental authority — who must be competent — signs the authorization meeting the law’s requirements. The adult accompanying the minor must be one previously authorized in accordance with the will of the person holding parental authority.

• That the person with parental authority be competent.Verified against the official source
• Signing a document with the requirements the law sets out, in the presence of the medical service provider or their administrative staff.Verified against the official source
• That consent be given before the medical treatments are provided.Verified against the official source
• That the adult accompanying the minor be previously authorized and prove their identity with official identification.Verified against the official source

• The consent-by-representation document, with the name and contact information of the person with parental authority, the authorized adult’s name, contact and relationship, the minor’s name and age, signature and date, the period of validity and the authorized treatments.
• Official identification of the authorized adult, who must present it at the time of treatment.

1. 1

   Step 1: Confirm the treatment is "non-urgent"

   The law defines non-urgent medical treatment as treatments that are not emergencies, and includes routine or follow-up treatments: for example, outpatient services, dental care, X-rays, laboratory tests, immunization, or any other health service with those characteristics. An emergency is governed by other rules, not by this authorization.

2. 2

   Step 2: Sign the document before the provider, not at home

   It is the requirement most often overlooked: the document must be signed in the presence of the medical service provider or their administrative staff. A paper signed and sent along with the companion does not meet the law as written. The other three requirements: that you be competent, that you sign a document with the law’s requirements, and that consent precede the provision of the treatments.

3. 3

   Step 3: Check the document carries everything the law requires

   The Department of Health must establish a uniform model, and the law lists its content: (a) information on the persons with parental authority granting it, including name and contact information with phone number; (b) information on the adult authorized to accompany the minor: name, contact information and their relationship to the minor; (c) the minor’s information: name and age; (d) the signature of at least one of the persons with parental authority; (e) the date of signature and how long the authorization will last, which may not exceed one year; and (f) the treatments, diagnoses or activities for which consent is granted.

4. 4

   Step 4: Decide whether to authorize everything or exclude something

   The law gives you both options expressly: the persons with parental authority may authorize all non-urgent treatments if they wish, and in that case the document must allow the person with parental authority to exclude any treatment, diagnosis or activity. That is, "everything except X" is an option the form must allow.

5. 5

   Step 5: Send the companion with official identification

   At the time of treatment, the minor must be accompanied by an adult previously authorized in accordance with the will of the person with parental authority, and that adult must prove their identity with official identification. Without that step, the authorization is not completed at the counter.

6. 6

   Step 6: If the parents disagree, the court decides

   The law anticipated the conflict: where there is a controversy between the persons with parental authority over the non-urgent medical treatments recommended by an authorized practitioner, the Court of First Instance must hear and resolve that controversy taking into account and safeguarding the minor’s best welfare.

The document is signed at the very office or institution where the treatment will be given, before the provider or their administrative staff, and the professional must include a copy of the duly completed and signed document in the minor’s medical record. The Department of Health has the duty to establish the uniform model so that all organizations, offices or places offering non-urgent treatment to minors adopt it and make it available. Controversies between those with parental authority are heard at the Court of First Instance.

• Signing the authorization at home and sending it with the companion: the law requires signing it before the provider or their administrative staff.
• Using the authorization for an emergency: the law covers non-urgent treatments.
• Leaving it without an expiration date: the document must state the period, which cannot exceed one year.
• Forgetting the authorized adult must bring official identification.
• Not specifying the treatments: the document must state the authorized treatments, diagnoses or activities, and allow excluding those you do not want.
• Assuming it works indefinitely: it must be renewed when the period expires.
• Believing the document resolves a disagreement between the parents: that controversy is resolved by the Court of First Instance.

These are the government pages this guide is based on.

• Departamento de Salud de Puerto Rico

  Salud

  bvirtualogp.pr.gov