Good Medical Consent Letter for Babysitter (FREE Sample)

Learn how to write a medical consent letter for babysitter. Use our sample medical consent letter for babysitter as a template for your medical consent letter.

Sample Medical Treatment Consent Letter For Babysitter

Name of Parent
Address of Parent
City, State, Zip Code

DATE

Name of Babysitter
Address of Babysitter
City, State, Zip Code

RE: Consent for Medical Treatment of Name of Child

To Whom It May Concern:

The intent of this letter is to give Name of Babysitter the authorization to take my four-year-old son Name of Son to Name of Doctor, Address of Doctor and Phone Number or Name of Hospital, Address of Hospital and Phone Number if there is a medical emergency or medical attention is required when I am not available.

Name of Babysitter is also permitted to give Name of Son OTC children’s Tylenol if he develops fever before reaching the doctor or hospital. Name of Son has no known intolerances or allergies to any medication. 

If required by the hospital or doctor, Name of Babysitter has permission to give Insurance Information. This authorization becomes invalid when Name of Babysitter is no longer in my employ. 


Sincerely,

Parent’s Signature
Parent’s Name Printed And Relation To The Child I.E. Mother, Father Of Child date of signing
Copies To: Name Of Hospital, Name Of Doctor, Name Of Babysitter, Name Of Insurance Agent Or Company

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