This article contains information on one way that certain nonparents can be allowed to consent to medical treatment of a minor child. After you complete this form, give a copy to each adult you have named to act on your behalf.This form is essential for situations where a child might require medical care, and the parents or legal guardians cannot be present to provide consent. I authorize this information to be released in written and verbal form. This file is a consent form for a non-parent to bring a minor child to a medical appointment. The signature of a minor patient is required for the release of some of these items.