Ensure your child's well-being with our easy-to-use child medical consent form. A grandparents' medical consent form allows a parent or legal guardian to hand over all responsibility regarding their child's healthcare decisions.In witness hereof, I have signed my name to this medical consent authorization, on this ____ day of ___________, 20__ in ___________________, Pennsylvania. Grandchildren that live with parents due to a legal adoption may be eligible for CHIP. When requesting form completion via MYCHOP, the completed form can be sent to your account to enable you to print, save or send it. A child medical consent form is a written document authorizing a designated adult to make healthcare decisions for a minor child. They may ask the court to grant full legal custody, partial legal custody, or visitation rights.